《黄帝内经素问遗篇》

The Remaining Chapters on Basic Questions of the Yellow Emperor’s Inner Classic are included in the Scripture of Nurturing and Cultivation of the Great Clarity in the Chinese Daoist Canon. The work comprises five fascicles: three, upper, middle, and lower, of “Treatise on the Needling Method,” and two, upper and lower, of “Treatise on the Root of the Disease.”

The Yellow Emperor asked Qibo: “I understand that when the ascent and descent of Qi are obstructed and cannot proceed at their appointed times, changes occur in the interaction of Qi, and sudden stagnation may result. How can we treat the people in advance so that these illnesses may be prevented?”

After paying his respects, Qibo replied: “That is a well-framed question. I have heard our founding teacher, Jiudaiji, say that understanding the patterns of Heaven’s cycles is not enough: one must also gain a thorough command of needling. Only then can one disperse stagnation, support the movement of Qi, replenish what is deficient, preserve upright Qi, and drain what is excessive, thereby relieving these afflictions.”

The Yellow Emperor said: “I would like to hear your explanation in detail.”

Qibo replied: “If the rising of Qi is obstructed, it can lead to grave danger. For example, Wood Qi should rise, but when it is blocked by the force known as the ‘Pillar of Heaven,’ it becomes stagnant and must wait for the right moment before it can set forth.”

The Yellow Emperor again asked him to explain in detail. Qibo repeated: “When Wood Qi is blocked and becomes stagnant, one must wait for the proper moment. At that time, the Jing-Well point of the Foot Jueyin channel may be needled. The Foot Jueyin channel is the Liver channel; a Jing-Well point is the first of the five transport points found on each of the twelve channels.”

The Well point of the Foot Jueyin channel is Dadun, located at the tip of the big toe, about the width of a leek leaf above the toenail, between the three fine hairs. It is where the Qi and blood of the Foot Jueyin channel emerge. At dawn (the first quarter of the water clock), press the point by hand. Once you feel the pulse, insert the needle to a depth of about three fen and retain it for six breaths. When Qi arrives beneath the needle, withdraw it quickly. Needle the left side first, then the right. Another method is to regulate the condition with emetic therapy on the day of the spring equinox; the specific procedure is not described here.

Fire Qi seeks to rise, but is suppressed by Tianpeng. It therefore becomes constrained and wants to flare up, yet must wait for the right moment.

Constrained Fire flares up only when the seasonal influence reaches the period governed by the Left Intermediary Qi. The time when Sovereign Fire is due to flare up is the spring equinox; for Ministerial Fire, it is Lesser Fullness. The methods for regulating Sovereign Fire and Ministerial Fire are therefore the same: both may be treated in advance with acupuncture before these periods arrive.

For both Sovereign Fire and Ministerial Fire, needle the Ying point of the Pericardium channel, where the channel’s Qi and blood flow abundantly.

The Ying point of the Pericardium channel is Laogong, located in the center of the palm. At the second quarter of the water clock, press the point by hand. Once you feel the pulse, insert the needle to a depth of about three fen and retain it for six breaths. When Qi arrives, withdraw the needle quickly, treating the left side first and then the right. Another method also uses acupuncture at Laogong, with the same procedure; the condition may also be treated by inducing perspiration in spring.

Earth Qi seeks to rise, but is suppressed by Tianchong. It therefore becomes constrained and wants to flare up, yet must wait for the right moment.

Constrained Earth flares up when the seasonal influence reaches the period governed by the Left Intermediary Qi. It flares up on the Wei days—that is, the days of Chen, Xu, Chou, and Wei—and most often during the period governed by the Second Qi. It may be treated in advance with acupuncture.

Needle the Shu point of the Foot Taiyin channel, where the channel’s Qi and blood penetrate more deeply.

The Shu point of the Foot Taiyin channel is Taibai, located in the hollow beneath the prominent bone on the inner side of the foot. It is where the Qi and blood of the Foot Taiyin channel pour in. Insert the needle at the third quarter of the water clock to a depth of about two fen and retain it for seven breaths. When Qi arrives, withdraw the needle quickly, treating the left side first and then the right.

Metal Qi seeks to rise, but is suppressed by Tianying. It therefore becomes constrained and wants to flare up, yet must wait for the right moment.

Metal Qi is held back in constraint as it waits for the right moment. Only when the course of the heavenly seasons reaches the day governed by the “left-side interstitial Qi” does Metal Qi begin to move. After the summer solstice, Metal Qi is about to shift from stagnation into movement. Once Fire Qi has grown strong, needling may be performed in advance.

Needle the Hand Greater Yin channel (Hand Greater Yin Lung channel).

The point referred to on the Hand Greater Yin channel is Jingqu, located in the hollow at the wrist pulse on each hand. It is a point along the course through which the channel Qi of Hand Greater Yin passes. When the pulse can be felt beneath the hand, needle when the water clock reaches four ke. Insert the needle three fen, measured by the patient’s own body proportions, and retain it for three breaths. When the Qi arrives and the pulse becomes rapid, withdraw the needle promptly. Needle the left hand first, then the right.

Water Qi is about to rise, but the heavenly seasons hold it back. As it is about to surge, it becomes constrained and must wait for the right moment.

When Water Qi is stagnant, wait until the course of the heavenly seasons reaches the time governed by the “left-side interstitial Qi.” Roughly after the boundary of the Chen position, when Fire Qi is strong, Water Qi can begin to move, and needling may be performed in advance.

Needle the He-Sea point of the Foot Lesser Yin channel, the point where channel Qi gathers and enters the internal organs.

The He-Sea point of the Foot Lesser Yin channel is Yingu, located behind the bone on the inner side of the knee, beneath the large tendon and above the small tendon. It can be felt beneath the hand when pressed and is easier to locate with the knee bent. This is where the channel Qi of Foot Lesser Yin gathers and enters. Needle to a depth of four fen, measured by the patient’s own body proportions, and retain the needle for three breaths. Needle when the channel pulse responds beneath the hand, then withdraw the needle promptly. Needle the left side first, then the right.

The Yellow Emperor said, “When rising and spreading cannot proceed smoothly, one may take precautions in advance. I would like to know about the descent of Qi: can that too be prevented and treated beforehand?”

Qibo said, “Taking precautions means protecting oneself in advance. Once you understand how the movement of Qi rises and spreads, you must also understand how it descends. Both rising and descending can be regulated in advance.” In other words, one may needle preemptively as Qi rises, to guard against what follows.

Wood Qi is about to descend, but Earth Qi obstructs it, preventing it from descending smoothly into its proper position. After being blocked, it becomes constrained and surges; once it disperses, it can return to where it belongs.

Fire Qi was expected to descend on the third day, but did not descend until the eighth. When Fire Qi is about to descend, stagnant Qi first disperses; only then does the Qi between Heaven and Earth take shape.

If stagnation flares up as Fire Qi descends, it comes on rapidly, like the Qi between Heaven and Earth waiting for its moment to break forth. If Fire Qi should descend but fails to do so, stagnation will form quickly.

When Fire Qi is slow to descend and stagnation is rapidly worsening, acupuncture should be performed promptly.

During acupuncture, the Qi of the phase that Fire Qi overcomes can be restrained.

This means restraining the outward signs of the Qi it overcomes while tonifying its root, so that this Qi is no longer excessive.

Needle Shaoshang, the point where Qi emerges on the Hand Taiyin channel (the Lung channel), the Jing-Well point of Hand Taiyin, located on the inner side of the thumbnail about a leek-leaf’s width from its corner. Also needle Quchi, the point where Qi enters on the Hand Yangming channel (the Large Intestine channel), the He-Sea point of Hand Yangming, located in the hollow between the two bones on the outer side of the elbow when the arm is bent. Insert the needle at Shaoshang about one fen, measured in proportional units based on the patient’s own body; retain it for two breaths, then withdraw it quickly. Insert the needle at Quchi about one cun and five fen; retain it for seven breaths, then withdraw it quickly once the Qi has responded beneath the hand.

Fire Qi is about to descend but is obstructed by the Dark Qi between Heaven and Earth, a deep and closed-off Qi. Fire Qi descends but cannot enter; suppressed, it stagnates and flares up. It is enough to disperse the stagnant Qi.

Fire Qi was expected to descend on the second day, but did not descend until the seventh. When Fire Qi is about to descend but the stagnation does not disperse, acupuncture should be performed promptly.

The Qi of the phase that Fire Qi overcomes should be restrained, thereby dispersing the stagnation.

When Fire Qi is stagnant, restraining Water Qi can eliminate the stagnation.

Needle Yongquan, the point where Qi emerges on the Foot Shaoyin channel (the Kidney channel), the Jing-Well point of Foot Shaoyin, located in the hollow on the front part of the sole. Also needle Weizhong, the point where Qi enters on the Foot Taiyang channel (the Bladder channel), the He-Sea point of Foot Taiyang, located in the center of the crease behind the knee.

The Jing-Well point of the Kidney channel, where channel Qi first emerges, is Yongquan, located in the hollow at the center of the sole. Flex the foot and curl the toes; the point lies in the deepest hollow of the sole. Insert the needle three cun deep and retain it for three breaths. When the Qi arrives and becomes urgent, withdraw the needle immediately. Needle the left side first, then the right.

The He-Sea point of the Bladder channel, where channel Qi converges, is Weizhong, located in the middle of the crease at the back of the knee, where the artery pulsates. Insert the needle five fen deep and retain it for seven breaths. Withdraw it immediately after the Qi arrives. Needle the left side first, then the right. Repeat the same needling method once.

Earth Qi seeks to descend, but is obstructed and suppressed by the green-blue Qi (Wood Qi), so it cannot descend. Once compressed, it accumulates and disperses; this allows it to flow freely again.

If it has still not descended after five days, it will descend on the tenth day. When Earth Qi is about to descend and the accumulated Qi begins to disperse, needle promptly.

The force that restrains and overcomes Earth Qi should be weakened so the accumulation can disperse.

When Earth Qi is accumulated, restrain the Water Qi that overcomes it; this can relieve the suffering caused by the illness.

Needle Dadun, the Jing-Well point of the Liver channel, and Yanglingquan, the He-Sea point of the Gallbladder channel. Dadun is at the tip of the big toe, beside the toenail, about the width of a leek leaf from its edge, between the three hairs. Insert the needle three fen deep and retain it for ten breaths; withdraw it immediately after the Qi arrives. Yanglingquan is in a hollow on the outer side of the fibula, about one cun below the knee. Insert the needle six fen deep and retain it for ten breaths; withdraw it immediately after the Qi arrives.

Metal Qi seeks to descend, but is obstructed and suppressed by the red Qi (Fire Qi), so it cannot descend. Once compressed, it accumulates and disperses; this allows it to flow freely again.

If it has still not descended after four days, it will descend on the ninth day. When Metal Qi is about to descend and the accumulated Qi begins to disperse, needle promptly.

The phase that overcomes it should be restrained to disperse the stagnation.

(When Metal Qi is stagnant, Fire is used to restrain Metal and dispel the stagnation.)

Needle Zhongchong, the Jing-Well point of the Hand Jueyin Pericardium Channel (the Pericardium Channel), and Tianjing, the He-Sea point of the Hand Shaoyang Sanjiao Channel. Zhongchong is at the tip of the middle finger, about the width of a leek leaf from the nail. As the Pericardium Channel’s Jing-Well point, it is needled to a depth of one fen, measured in proportional body inches. Retain the needle for two breaths, then withdraw it quickly once Qi has arrived. Tianjing lies in the hollow between two tendons, behind the large bone on the outer side of the elbow and one inch above the tip of the elbow. It can be located with the elbow bent. As the Sanjiao Channel’s He-Sea point, it is needled to a depth of one inch and retained for ten breaths. Once Qi arrives beneath the needle and a response can be felt in the hand, withdraw it quickly.

Water Qi should descend, but it is obstructed and pressed down by Earth Qi, so it cannot do so. Once compressed and stagnant, it disperses; after dispersing, it can continue to circulate.

(If Water Qi has not descended for a whole day, it will descend on the sixth day. It should move downward, but stagnation makes it disperse, so needling may be performed in advance.)

The Earth Qi that overcomes it should be restrained to disperse the stagnation.

(Restraining the phase that overcomes it can disperse the stagnation.)

Needle Yinbai, the Jing-Well point of the Foot Taiyin Spleen Channel, and Zusanli, the He-Sea point of the Foot Yangming Stomach Channel. Yinbai is at the end of the big toe, on the side near the nail, about the width of a leek leaf from it. As the Spleen Channel’s Jing-Well point, it is needled to a depth of one fen, measured in proportional body inches, and retained for three breaths; withdraw the needle once Qi has arrived. Zusanli lies three inches below the knee, in the hollow on the outer side of the shinbone. As the Stomach Channel’s He-Sea point, it is needled to a depth of five fen, measured in proportional body inches, and retained for ten breaths; withdraw the needle quickly once Qi has arrived.

The Yellow Emperor said, “When the Five Phases (Wood, Fire, Earth, Metal, and Water) move into operation, their Qi comes in sequence, rises and descends, and shifts back and forth. It may also be supported or restrained. Can these conditions be regulated through acupuncture? Please explain the essentials.”

Qibo replied, “Treatment should address the source of the Qi’s transformation. When the movement of Qi is excessive, restrain it; when it is insufficient, support it. In cases of excess, first disperse what is stagnant, then work from the source of that movement’s transformation so the congested Qi can settle. When the movement is insufficient, support and supplement it, strengthening the Qi of that movement to ward off Empty Pathogenic Qi—harmful influences that take advantage of the body’s weakness.

“When the movement of Qi is insufficient, support the source of its transformation and replenish what is depleted, so it will not be suppressed.

“The specific methods for supporting and restraining the movements of Qi are given in the Secret Instructions, an abbreviation of the Mysterious Pearl’s Secret Instructions. Methods for supporting the source of Qi’s transformation and restraining it are explained in the first volume of the Mysterious Pearl’s Secret Instructions.

The Yellow Emperor’s Inner Classic: Basic Questions, Lost Chapters, Volume One

On the Essentials of Acupuncture

The Yellow Emperor asked, “The key to acupuncture that regulates rising and descending Qi lies in mastering its essentials. I would like to ask: if the Qi governing Heaven—that which presides over the year’s seasonal conditions—has not yet shifted into its proper position, causing the forces that govern Qi transformation to become irregular, disrupting the patterns by which all things change, and making the people ill, can these conditions be prevented in advance? To aid all living beings, please explain the principles.”

A commentary explains: by determining when the Qi governing Heaven will shift into its proper position, one can prevent and treat illness in advance.

After performing the formal kneeling bow, Qibo said, “Your questions are exceptionally thorough. They touch on the deepest principles, and your enlightened heart is filled with compassion and a wish to save the people. I will set out all the principles involved, so that their profound and subtle aspects may be made clear.”

When the Qi of Greater Yang circulates again, the Qi of Jueyin cannot return to its proper place at the appointed time.

(This means that the movement of Heaven and Earth is out of balance and the Qi of the four seasons is out of harmony, giving rise to epidemic diseases.)

When the Qi of Jueyin cannot return to its proper place, Qi becomes congested in the upper body. One should drain the point where the Qi of the Foot Jueyin channel flows.

(The movement of Qi has opened out and then become obstructed, so draining is called for. The point where the Qi of the Foot Jueyin channel flows is Xingjian, in the hollow between the big toe and the second toe where the artery pulses. It is the Ying-Spring point of the Foot Jueyin channel. Insert the needle about six fen and retain it for the time of seven breaths. Once Qi arrives, withdraw the needle swiftly.)

When the Qi of Jueyin circulates again, the Qi of Shaoyin cannot return to its proper place at the appointed time.

(Heaven and Earth are out of step with the seasons, so the movement of the climate becomes irregular.)

When the Qi of Shaoyin cannot return to its proper place, Qi becomes congested in the upper body.

(Heat is about to arise, but Wind-Qi spreads outward.)

One should needle the point where the Qi of the Hand Jueyin Pericardium channel flows.

(This refers to Laogong, located in the center of the palm. Insert the needle about three fen and retain it for the time of six breaths. Once Qi arrives, withdraw the needle swiftly.)

When the Qi of Shaoyin circulates again, the Qi of Taiyin cannot return to its proper place at the appointed time.

(The years of Zi and Wu have an excess of days, so the Qi dynamics of the years of Chou and Wei cannot occupy their proper position.)

When the Qi of Taiyin cannot return to its proper place, Qi remains in the upper body.

(Rain and Dampness are about to arise, but Heat spreads through the sky.)

One should needle the point where the Qi of the Foot Taiyin channel flows.

(This refers to Dadu, in the hollow behind the joint at the base of the big toe. It is the Ying-Spring point of the Foot Taiyin channel. Insert the needle about three fen and retain it for the time of seven breaths, then withdraw it.)

The Ying point of the Foot Taiyin channel, where the channel’s Qi flows and gathers, is Dadu. It lies in the hollow behind the joint at the base of the big toe. Insert the needle to a depth of three body-measure inches and retain it for seven breaths. Once Qi arrives, withdraw the needle.

When Taiyin Qi circulates again, Shaoyang cannot move into its ruling position in the heavens at the appointed time.

(In Chou and Wei years, the allotted heavenly influence exceeds its proper measure. By Yin and Shen years, Shaoyang Qi has still not taken its proper position.)

When Shaoyang fails to move into its proper position on time, the flow of Qi becomes blocked.

(Heat Qi was due to transform and arise, but rain Qi has instead spread across the heavens.)

At this time, needle the Ying point of the Hand Shaoyang channel.

The Ying point of the Hand Shaoyang channel is Yemen, in the hollow between the little finger and ring finger. Insert the needle to a depth of two body-measure inches and retain it for three breaths. Once Qi arrives, withdraw the needle promptly.

When Shaoyang Qi circulates again, Yangming cannot move into its ruling position in the heavens at the appointed time.

(In Yin and Shen years, the allotted heavenly influence exceeds its proper measure. By Mao and You years, Yangming Qi has still not received its position as ruler of the heavens.)

When Yangming fails to move into its proper position on time, the flow of Qi cannot ascend and pass through.

(Dryness Qi was due to govern the heavenly season, but heat Qi has returned to take charge.)

At this time, needle the Ying point of the Hand Taiyin channel.

The Ying point of the Hand Taiyin channel is Yuji, on the inner side behind the joint at the base of the thumb, where the pulse markings are visible. Insert the needle to a depth of two body-measure inches and retain it for three breaths. Once Qi arrives, withdraw the needle promptly.

When Yangming Qi circulates again, Taiyang cannot move into its ruling position in the heavens at the appointed time.

(The allotted heavenly influence of Mao and You years has not yet run its course. By Chen and Xu years, Taiyang Qi has still not taken its proper ruling position.)

When Yangming Qi circulates again, Taiyang cannot move into its proper position on time.

(The allotted heavenly influence of Mao and You years has not yet run its course. By Chen and Xu years, Taiyang Qi has still not taken its proper ruling position.)

When Taiyang fails to move into its proper position on time, the flow of Qi is obstructed once more.

(Cold Qi was due to circulate through the heavenly season, but dryness Qi has returned to transform and act.)

At this time, needle the Ying point of the Foot Shaoyin channel.

The Ying point of the Foot Shaoyin channel is Rangu, in the hollow in front of the inner ankle, beneath the prominent bone. Insert the needle to a depth of three body-measure inches and retain it for three breaths. Once Qi arrives, withdraw the needle.

(In the text, “Hand Shaoyang,” “Foot Shaoyin,” and similar terms name channels. “Moving into its proper position” means taking up the corresponding seasonal position and governing it at the appointed time. An Ying point is one of the Five Shu points of a channel.)

The Yellow Emperor asked, “When the Six Qi shift into their proper positions, if the succession does not occur on time, how can we grasp the key to it? I want to know how, when a Qi fails to withdraw from its position, we can diminish its excess so that it does not cause harm.”

Qibo replied, “If a Qi continues beyond its proper term, it will once again issue its governing commands. This is called ‘failing to leave its position’: the former Qi that governs the heavens continues in charge and cannot withdraw.”

As a result, Earth Qi cannot complete the changes that follow in due time, and the new year’s Qi that governs the heavens cannot take its proper position. The old Qi therefore resumes issuing its directives, and conditions remain the same as in the previous year. The new year’s governing Qi has not yet taken the leading position, while the previous year’s governing Qi still directs the seasons. The course of the seasons is thus thrown out of balance, readily bringing disaster and illness to the people.

In Si and Hai years, the number of the heavenly seasons is in excess, so Jueyin Qi cannot withdraw from its position. It continues to govern the seasons in Zi and Wu years. Wind Qi moves above, and the transformations of Wood Qi spread through the heavens. The influence of rain and dampness cannot operate normally; when Wind Qi becomes excessive, it may bring disaster. At this time, one should needle the entry point of the Foot Jueyin channel, namely Ququan. Ququan is on the inner side of the knee, in the hollow between the tendons when the knee is bent. The commentary says to insert the needle six fen deep and retain it for seven breaths; when the Qi beneath the needle moves rapidly, withdraw it quickly.

In Zi and Wu years, the number of the heavenly seasons is in excess, so Shaoyin Qi cannot withdraw from its position. It continues to govern the seasons in Chou and Wei years. Heat Qi moves above, and the transformations arising from the lingering force of Fire Qi spread through the heavens. Dryness and coolness are insufficient, and rain cannot operate normally, so Heat Qi continues to govern the seasons. At this time, one should needle the entry point of the Hand Jueyin channel.

The entry point of the Pericardium Channel is Quze (Crooked Marsh), the He-Sea point of the Hand Jueyin Pericardium Channel. It lies in the hollow on the inner side of the elbow and is located with the elbow bent. This point is needled when the Hand Jueyin Channel is in season. Insert the needle three fen deep (a depth measured in ancient times using the proportional body-inch), retain it for seven breaths, then withdraw it quickly once Qi has arrived.

In years of the Chou and Wei branches, the measure of Heaven’s timing is in excess, so Taiyin Qi does not withdraw from its position at the appointed time.

(Thus, in years of the Yin and Shen branches, Taiyin Qi continues to govern Heaven’s timing.)

Dampness moves above, and the transformation of rain spreads through Heaven.

(The influence of cold weakens, heat cannot issue its commands, and dampness spreads anew to govern Heaven’s timing.)

The entry point of the Foot Taiyin Channel should be needled.

(The entry point of the Foot Taiyin Channel is Taibai? No: Taiyin Lingquan point. It lies in the hollow below the accessory bone on the inner side of the lower leg and is the He-Sea point of the Foot Taiyin Spleen Channel. Insert the needle five fen deep, retain it for seven breaths, then withdraw it quickly once Qi has arrived.)

In years of the Yin and Shen branches, the measure of Heaven’s timing is in excess, so Shaoyang Qi does not withdraw from its position at the appointed time.

(Thus, in years of the Mao and You branches, Shaoyang Qi continues to govern Heaven’s timing.)

Heat moves above, and the transformation of fiery heat spreads through Heaven.

(The influence of dryness and coolness weakens, and heat once again takes charge and spreads to govern Heaven’s timing.)

The entry point of the Hand Shaoyang Channel should be needled.

(The entry point of the Hand Shaoyang Channel is Tianjing (Heavenly Well). It lies in the hollow between the two tendons, behind the large bone on the outer side of the elbow and one cun above the back of the elbow. It is located with the elbow bent and is the He-Sea point of the Hand Shaoyang Sanjiao Channel. Insert the needle three fen deep; once Qi has arrived, withdraw it quickly.)

In years of the Mao and You branches, the measure of Heaven’s timing is in excess, so Yangming Qi does not withdraw from its position at the appointed time.

(Thus, in years of the Chen and Xu branches, Yangming Qi continues to govern Heaven’s timing.)

Dryness moves above, and the influence of dryness spreads through Heaven.

(The influence of wind weakens, cold cannot issue its commands, and coolness once again takes charge and spreads to govern Heaven’s timing.)

The entry point of the Hand Taiyin Channel should be needled.

The He-Sea point of the Hand Taiyin meridian (Lung channel) is Chize, located in the middle of the crease at the elbow, where a pulse can be felt. The needling depth is three proportional body inches, measured according to the patient’s body; retain the needle for the time of three breaths. Once Qi arrives, withdraw the needle swiftly.

In Chen and Xu years, the celestial influence is excessive, so the Qi of Taiyang cannot withdraw from its position on schedule. Even when Si and Hai years arrive, it still presides over the celestial influence.

Cold Qi moves above, and the Qi of cold Water spreads across the heavens. The influence of Heat weakens, the influence of Wind cannot be exerted, and the influence of Cold once again presides over the celestial influence.

At this time, needle the Ying-Spring point of the Foot Shaoyin meridian (Kidney channel), namely Yinggu. Yinggu is located on the inner side of the knee, behind the medial bone and beneath the large tendon. It responds to pressure and is easier to locate when the knee is bent. It is the He-Sea point of the Foot Shaoyin meridian. Needle to a depth of four fen, and withdraw the needle once Qi arrives.

Thus, when the Qi of Heaven and Earth runs out of order, its transformations in Qi give rise to illness among the people. Needling in accordance with the relevant principles can treat and settle illness in advance. The Qi of the human body is connected with Heaven and Earth. When the interaction of Qi changes, examine the sequence of its movements, its excess or fullness, and whether it has withdrawn from its position; then needle the corresponding points to treat the condition from beginning to end.

The Yellow Emperor asked: “When the firm and yielding stems lose their proper positions, does this cause all the Qi of the celestial movements to become deficient? If this brings illness to the people, can it still be treated and settled?”

Qibo replied: “A profound question. Do you understand the forms this deficiency takes? When the Qi of the celestial movements becomes deficient, it can be treated by needling in accordance with the principles.”

As the Qi of Heaven and Earth shifts in turn, pestilence forms every three years. From this we can see the source of pestilence, and there must also be a way to avoid danger and preserve life.

Suppose that in a Jiazi year, the firm and yielding stems fail to keep their proper positions…

Softness (the Yin quality of Qi) may occupy its allotted position while the firm Qi above it has not yet arrived. Even when the seasons have begun to change, the appointed time for the transition may not yet have come. In the first half of a Jiazi year, the current influence may not yet have completed its tenure; in the second half of a Jimao year, it may already have moved into its proper position. This is called the soft stem being isolated and deficient below. The firm Qi has not yet returned to its proper position, and Ji Earth cannot join with Jia Wood. As a result, the Earth phase becomes weak, and Wood Qi takes advantage of the weakness and prevails.

When the firm Qi has not yet returned to its proper position, the soft Qi is left isolated and diminished.

Jia Wood cannot join with Ji Earth, so the Earth phase cannot govern normally. The seasonal order becomes disrupted, and the Qi of Lesser Yin cannot develop normally. Thus both the weather and the cyclical Qi are weakened, allowing pathogenic Qi to take advantage of the weakness and transform, causing an epidemic.

When the seasonal order is disrupted, the pitch tones also fall out of harmony.

The Qi governing Heaven—the influence that governs the weather in the first half of the year—is still spreading, while the central cyclical movement, which governs the Five Phases throughout the year, has already been disturbed by an opposing influence. Jia Wood has not yet arrived, while Ji Earth has arrived early. A pitch that should sound remains silent, while a pitch that should remain silent sounds instead. In other words, the Huangzhong Great Gong tone fails to resonate, while the Jiazhong Lesser Gong tone sounds. This anomaly can be recognized through outward signs: in the second half of a Jimao year, Ji Earth stands isolated and bears the Earth phase alone.

If this condition persists for three years, it will turn into a major epidemic.

When the condition is severe, the epidemic comes quickly; from its beginning to its end, it lasts three years.

One must carefully assess the severity of the illness and whether its location is superficial or deep. The sounding of the Jiazhong Lesser Gong tone is an outward sign; in the second half of a Jimao year, Ji Earth stands isolated and bears the Earth phase alone.

If this condition persists for three years, it will turn into a major epidemic.

When the condition is severe, the epidemic comes quickly; from its beginning to its end, it lasts three years.

One must carefully assess the severity of the illness and whether its location is superficial or deep.

If the cyclical Qi is greatly deficient and abnormal governance continues for a long time, the illness is likely to be deep-seated; the deeper its location, the more severe it will be. The annual movement has not yet returned to its proper position, while an opposing influence has disturbed it for a prolonged period; this, too, indicates a severe, deep-seated illness. The “two years, from beginning to end” mentioned here means that the condition lasts for two years from its onset to its conclusion.

When an epidemic is about to break out, acupuncture may be used.

This passage explains a method of acupuncture: once the proper Qi has begun to circulate with the seasons but has not yet moved into its proper position, acupuncture may be used to treat illnesses caused by the current season. The text stresses that one should first determine the illness’s severity and whether its location is superficial or deep, then prepare treatment in advance. If a major epidemic is expected within three years, acupuncture and tonifying methods should be used to help the body resist it.

First, tonify Shenshu, the kidney-shu point on the back, an acupuncture point.

When “earth pestilence” appears in someone with weak Kidney Qi, first tonify the Kidney Shu point, an acupoint on the back associated with the Kidney channel. The Kidney Shu point lies below the fourteenth vertebra, one cun and five fen to either side of the spine; measure the distance according to the proportions of the patient’s own body. Before needling, warm the needle in the mouth, then use a rounded-tip needle, a tool with a tip that is rounded yet sharp.

As you prepare to needle, recite the incantation: “True Ones of the Five Emperors, mysterious spirits of the Six Jia; the Qi talisman reaches Yin, all baleful influences are sealed away.” After reciting it three times, take the needle from the mouth and insert it two fen, retaining it for six breaths, counted by the patient’s breathing. Then advance it to three fen. When Qi arrives beneath the needle, withdraw it slowly and press the point with your hand, while the recipient swallows their breath three times. This can also calm the spirit and hun-soul.

Three days later, needle the Shu-Stream point of the Foot Taiyin Spleen channel, the point where the channel’s Qi pours in: Taibai. Taibai lies in the hollow below the inner ankle bone. First warm the needle in the mouth. As you insert it, recite the incantation: “The Emperor supports the form of Heaven, protecting life and bringing forth spirit.” After reciting it three times, insert the needle three fen and retain it for seven breaths. When Qi arrives beneath the needle, withdraw it quickly.

There is another case: the lower Ji-Mao Qi has not arrived, while the Jia-Zi Qi stands alone. In this situation, an “earth pestilence” associated with Earth Qi will occur three years later. The tonifying and draining methods for treatment follow the same method as in the Jia-Zi year.

The circumstances described here occur when the Qi above and below fail to keep their proper positions in a Jia-Ji year. The same method applies in the years Jia-Zi, Jia-Xu, Jia-Shen, Jia-Wu, Jia-Chen, Jia-Yin, and Ji-Chou, Ji-Hai, Ji-You, Ji-Wei, Ji-Si, and Ji-Mao.

After completing the needling and moxibustion, there is no need to travel at night or go on a long journey. Keep the body and mind clean for seven days, quiet the mind, and observe a purifying fast. Those with chronic kidney disorders may face south at the Yin hour (3–5 a.m.), settle the spirit, and let their thoughts become still. Hold the breath seven times, then tilt the head back and swallow the breath as it rises, as though swallowing something very hard. Repeat this seven times, then swallow the fluids beneath the tongue as often as desired.

The immortals teach that swallowing breath makes one’s roots deep and secure, as a child receives the breath of its mother. After swallowing the breath, let the abdomen resound until the “child-breath” below the navel joins with the “primordial mother-breath.” This is therefore called “returning to the root and restoring the origin.” Swallowing breath over a long period deepens one’s foundation and steadies one’s roots. The fluids beneath the tongue are called the “water of the Celestial Pool,” and are also known as the “water of the Palace of Li,” the “Jade Pool,” or “spirit water.” They should be swallowed, not spat out. The scripture says that swallowing these fluids replenishes Jing and blood, nourishes the Five Viscera, and first moistens the Primordial Sea, the place where primordial Qi is stored.

If the year is Bingyin, the forces of softness and firmness do not combine in their usual way.

The claim that the soft force is in its proper position while the firm force has failed to hold its own means that, although it is a year of transition, the Qi of the Bing year has not yet moved into its proper position to govern the world. Only the Qi of Xinsi governs the Qi below. The Bing stem above has lost its firm, vigorous nature, so the Water phase cannot take the center and govern. Although the Water phase is said to be excessive, in practice it is instead subdued by Earth Qi.

When the firm stem above fails to hold its position, the soft stem below cannot govern on its own.

A soft stem above already indicates that the Qi cycle is insufficient; all the more so when it has lost the support of the firm stem, for then it cannot govern by itself.

The central movement belongs to Water, but it is not truly excessive and cannot be judged directly by a fixed rule.

One cannot assume that the Water phase is excessive in every Bing year. The changes in the seasons must be calculated to discern where it falls short.

Heavenly Qi may be in excess, yet it has lost its proper position as governor.

Although Heavenly Qi is directing the transformations, this only means that its Qi is being distributed; it does not mean that it has taken its proper position. The force that should normally govern the Qi of the year has not yet returned to its place.

When the Qi of Heaven and Earth are out of harmony, the pitches corresponding to the Lü and Lü (the ancient system of pitches, also used to coordinate Yin-Yang and the seasons) will differ as well.

When the soft stem arrives, the Lü and Lü have a corresponding sound, but the firm stem has not yet moved into its proper position.

When Heaven and Earth lose their harmony, the sounds corresponding to the rhythmic pitch system (lü-lü, the ancient system for determining musical pitches and symbolizing the Yin-Yang energies of Heaven and Earth) also become abnormal.

If a soft stem (a Yin stem) arrives and the Lü pipes produce the corresponding sound, while the firm stem (a Yang stem) has not yet changed and the Lü pipes remain silent, the sound of the lesser Yu pitch will ring out, while the greater Yu pitch will….

This indicates that the movements of Heaven have lost their order. Even if transformation through Qi still occurs, it is no longer normal. In the third year that follows, an epidemic transformation will occur.

Epidemic transformations may be mild or severe, so they may begin sooner or later. One should calculate the days and determine the extent of the deviation in the movement of Qi. Careful examination shows that deviations vary in degree: a major deviation is seven divisions, and a minor one is five; each division equals fifteen days. A major deviation takes effect quickly, while a minor one develops more slowly. A slower onset appears only in the third year; a very severe onset appears within the first three years. By calculating how quickly the deviation takes effect, one can determine the degree of delay in the movement of Qi.

First, one should tonify the Heart Shu point, a back point associated with the heart.

The Heart Shu point lies below the fifth vertebra, one and a half cun to either side of the spine. Use a round-tipped sharp needle. At noon, warm the needle, then press the point with the hand. When movement of Qi is felt beneath it, recite the incantation: “Supreme Clarity of the Great Beginning, Elixir Origin guards the spirit.” Recite it three times. First visualize a flame beneath the point, then insert the needle one and a half cun and retain it for seven breaths. When Qi arrives, advance the needle three fen. Flick the needle with the hand to direct the sensation of Qi downward. When the sensation reaches its destination, slowly withdraw the needle. Then press the needle hole with the hand, have the recipient hold their breath for three breaths, and then swallow the breath.

After five days, one may needle the Kidney Channel’s He-Sea point, where the channel’s Qi gathers and which is associated with the internal organs.

The Kidney channel’s point is Yin Valley, located behind the bone on the inner side of the knee, beneath the large tendon and above the small tendon. The point can be felt by pressing, and is easy to find with the knee bent. When using a round-pointed needle—a type of needle with a sharp tip and a smooth, rounded shaft—first keep the mouth warm, then press the point with the hand and recite the incantation: “Great Subtle Emperor Lord, the five Qi and the Real; the Six Xin, all in command; the talisman supports the dark clouds.” After reciting it once, insert the needle to a depth of about four body-inches, measured according to the patient’s own body. When Qi arrives and movement is felt at the point, withdraw the needle quickly.

Another case is the lower-position Earth Jiazi, Xin-Si. The Yin stem Xin and the Yang branch Si do not correspond; this is also called “failing to hold one’s position,” meaning that the Earth movement is weakened. Three years later, a water pestilence—a disease associated with water Qi—will occur. The needling method is carried out in the same way.

For example, the stem-branch combinations Bing-Yin, Bing-Zi, Bing-Xu, Bing-Shen, Bing-Wu, and Bing-Chen, as well as Xin-Chou, Xin-Hai, Xin-You, Xin-Wei, Xin-Si, and Xin-Mao, all count as a failure of the firm and yielding to hold their positions. This is also called “failing to hold one’s position,” meaning that the Earth movement is weakened. Three years later, a water pestilence will occur, and the needling method is carried out in the same way.

In all such cases where the upper and lower positions fail to hold, calculate the differences in degree between them before needling.

After needling, regulate and care for yourself cautiously. Do not let excessive joy or sexual desire disturb the heart. Without restraint, Qi will disperse again, so rest quietly for seven days.

After seven days, the Shen-Qi will be full, and water pestilence will not harm you.

To make the heart-Qi full, one should think less.

Thinking damages the Shen. In daily life, keep the heart clear and still, so that the Shen remains within. Then the Dao will naturally descend, and Qi will rise again. If a person’s thoughts are confused and scattered, consuming the Shen, this will wear down the heart and Shen under the influence of the ghost kings within Yin. The person’s spirit will be put to work, the will made to suffer, and the heart left in turmoil; in this way, the lifespan is shortened. To be full means that the Shen and will are at peace; a still heart is a state of harmony and balance.

Suppose the year is Geng-Chen and the firm and yielding fail to hold their positions: Yi occupies the position it should, while the upper position has lost Geng. This is called the yielding losing its firmness. Although Yi has attained its position for the year, Geng is not in the central position; Yi is in the lower position, and ◇ governs its Earth. The upper position’s Geng has lost...

Yi (an Yin stem) occupies the lower position, while the upper position lacks Geng (a Yang stem) to pair with it. This is called softness deprived of firmness. Although the year brings the combination of Yi and Geng, Geng does not occupy the middle position; Yi occupies the lower position and governs the Earth Qi. The upper position has lost its Yang, firm stem, so the Metal Qi of the central movement cannot become excessive. Instead, it is restrained by Fire Qi.

The upper position has lost its governing Qi, and the lower position likewise lacks a corresponding Qi to pair with it.

Yi does not govern Earth Qi in the lower position and is left isolated. Nor is there a Yang, firm stem above to correct it, so the heavenly movement is vacant.

Yi and Geng should combine to form a Metal movement, but here they do not respond to one another.

Only when the Qi above and below respond to each other do Yin and Yang combine, allowing the Qi governing Heaven and the central movement each to perform their proper functions.

The Qi arrayed in Heaven has not yet withdrawn, while the Qi of the central movement has already arrived and gained the upper hand.

This is not the usual alternation of prevailing Qi and counteracting Qi in a Yang year, because the earthly branch and heavenly stem have not combined.

When the Qi above and below are out of alignment, this is called a failure to hold their positions.

Geng has not joined with Yi in a corresponding combination.

The Shang tones assigned to Guxi, the pitch pipe corresponding to the upper register, and Linzhong, the pitch pipe corresponding to the lower register, do not resonate with each other.

When positions are not maintained, tones and Qi of the same kind cannot resonate with one another. Guxi corresponds to Gengchen, whose Great Shang tone cannot resonate properly; Linzhong corresponds to Yiwei, whose Lesser Shang tone resonates alone.

In these circumstances, the changes in the heavenly movement will shift.

As a result, the seasonal changes in climate will no longer be normal.

A widespread epidemic will occur three years later.

This epidemic belongs to Metal and is called a “Metal epidemic,” also known as a “killing epidemic.”

The variations in the movement of seasonal timing must be examined carefully, since deviations can be slight or severe.

When the deviation reaches seven-tenths, abnormal weather lasts for more than 105 days and the illness is severe. When it reaches five-tenths, abnormal weather lasts for more than 75 days and the illness is milder.

When the illness is mild, it develops slowly and arrives three years later.

When it is severe, it develops rapidly and arrives three years later.

First, supplement the Liver Shu point, the back-shu point associated with the liver, used in acupuncture to regulate Liver Qi.

Once the location of Ganshu (Liver Shu) has been identified—below the ninth vertebra on the back, one and a half cun to either side—use a rounded sharp needle, a needle with a rounded yet keen tip. First warm the needle by breathing on it, then press the point with your hand. When you feel Qi moving beneath it, prepare to insert the needle and recite the incantation: “Qi from the Beginning, clear; the Emperor’s talisman of the Six Ding. To the left, establish the Azure City; to the right, enter the Yellow Court.” Recite it three times. First imagine blue-green Qi gathering beneath the point, then insert the needle three fen. Once Qi has been obtained, advance the needle to five fen. When Qi arrives, slowly withdraw the needle while pressing the point with your hand, and have the recipient swallow Qi down beneath the point. Then insert the needle three fen again in the same way. Once Qi has been obtained, advance it to five fen; when Qi arrives, slowly withdraw the needle and press the point, while having the recipient swallow Qi.

Three days later, you may needle the place where Lung Qi travels.

The place where Lung Qi travels is the Jingqu point, in the hollow at the wrist pulse, on the Hand Taiyin channel, the Lung channel on the inner arm. Use a rounded sharp needle, first warming it with your breath. Then press the point with your left hand and recite the incantation: “The Supreme True Ones of the Great Beginning, the Five Talismans and Emperor Lords; primordial harmony joins with Qi, directing it to enter the spirit.” Recite it three times, then insert the needle three body-measured fen, using the patient’s own body as the measure. Retain the needle for the time of two breaths, and withdraw it once Qi arrives.

After needling, rest quietly for seven days and carefully avoid great anger; anger causes true Qi to withdraw and disperse. If the earthly Jiazi or Yiwei is found to have lost its guard, this is a soft stem. If the heavenly Geng governs alone, this too is called losing its guard, or being an isolated ruler. Three years later, a pestilence will occur, called the “Metal Pestilence,” also known as the “Slaying Pestilence.”

The time when pestilential Qi arrives can be determined by considering the differences in the earthly numbers and assessing its severity; this reveals whether it will come early or late. If it comes swiftly, it will arrive within three years; if late, it will arrive in the following three years. Its outbreak is like that of a metal pestilence, and the needling method is the same as described above. When the various Yi and Geng positions lose their guard, the needling method is also the same.

In other words, the seasons and celestial influences run their courses in different ways. In a Ding year, when Metal Qi governs, there will be a calamity of harsh decline, and the illnesses suffered by the people will be alike; acupuncture can be used to dispel this influence.

Liver Qi seeks to remain calm, so people should not become angry.

Anger causes Yin Qi to arise. The liver belongs to Yang, and its spirit is the Hun (ethereal soul). When Yin Qi arises, Yang Qi is harmed. At night, when sleeping, one should keep the mind settled and avoid reciting malicious words. In this way, the Yang spirit can remain within the body.

Suppose that in a Renwu year, the forces of firmness and flexibility have failed to perform their proper duties.

The Earth Qi below has taken its position, but the Heavenly Qi above has lost its governing power. When the Qi that governs the heavens issues its commands, the Wood movement is instead weak. Even as the seasons change, the Heavenly Qi has not yet shifted into its proper position, while the central movement has already gained the upper hand. The Earth Qi therefore displays the pattern of Dingyou and alone governs transformation. As a result, Dryness prevails in the course of the year over the Heavenly Qi, and the expected transformation into Heat has not yet appeared. This is called “double deficiency.”

The Ren Qi above has not yet shifted into its proper position, while the Ding Qi below has appeared on its own. Thus, even in a Yang year, the circumstances of deficient Qi movement can differ.

The calamities follow the same pattern. After three days, the liver falls ill on its own. Wind Qi cannot carry out its transformations as it should, and the Ren Qi of the year’s movement has not yet taken its position. If the Heavenly Qi shows signs of retreat, it may shift into its proper position; there is no need to wait until it has returned before the Jiao tone is restored to its proper state.

The upper and lower realms have both failed in their proper duties and respond to one another through mutual influence. Thus, even in a Yang year, the circumstances of deficient Qi movement can differ.

The calamities follow the same pattern. After three days, the liver falls ill on its own. Wind Qi cannot carry out its transformations as it should, and the Ren Qi of the year’s movement has not yet taken its position. If the Heavenly Qi shows signs of retreat, it may shift into its proper position; there is no need to wait until it has returned before the Jiao tone is restored to its proper state.

When the upper and lower realms fail in their duties and influence one another, this too follows a set number of days.

To calculate the deviation in the Heavenly Qi, one must also consider how far it has strayed. Only after the Heavenly Qi returns to its proper position will the upper and lower realms respond to one another again.

Deviations may be slight or severe, and each has its own corresponding duration.

A deviation of seven tenths is calculated as 105 days, the longer period for a substantial deviation. A deviation of five tenths lasts 75 days; smaller deviations last for shorter periods.

When the upper and lower Jiao tones are out of harmony, they are both Jiao tones, yet there will be a date when tones of the same kind respond to one another.

Here, the upper influence is the Lü of Ruibin, and the lower is the Lü of Nanlü. The upper, greater Jiao tone does not respond, while the lower, lesser Jiao tone answers it; thus the two Jiao tones are out of harmony. Later, on the day Renwu shifts into its proper position, the upper and lower Jiao tones will respond to one another in unison.

When the deviation, whether slight or severe, reaches a pronounced degree, a major epidemic will occur within three years.

A slight deviation will persist until the Yiyou year, while a severe one will persist until the Jiashen year. During this time, the Jiao tones remain out of harmony. Later, on the day Renwu shifts into its proper position, the upper and lower Jiao tones will respond to one another in unison.

Whether the illness is mild or severe, a widespread epidemic will break out in the years of Jia Shen and Yi You. Severe cases come on quickly; mild cases develop slowly.

Needle Spleen Shu, the back-shu point of the spleen, located below the eleventh thoracic vertebra, one and a half cun to either side. Before using a round-pointed needle, warm the mouth and recite the incantation three times: “Five essences, wisdom essence; six jia, numinous mystery; the Emperor’s talisman, primordial head; Fire first received the truth.” First visualize yellow Qi gathering beneath the point, then insert the needle two fen. When Qi arrives, advance the needle; when Qi is felt to move, advance it again. Advance it by one fen on each of these two occasions. Retain the needle for five breaths, then withdraw it slowly and press the needle hole with the hand. Have the patient keep their breathing steady. Repeat this three times, then swallow the saliva in the mouth.

Three days later, needle the point where the Liver channel emerges, using the same method: first insert the needle two fen; when Qi arrives, advance it; when Qi is felt to move, advance it again, one fen each time. Retain the needle for five breaths, then withdraw it slowly and press the needle hole. Have the patient keep their breathing steady, repeat three times, then swallow the saliva.

Three more days later, needle Dadun, the Jing-Well point of the Liver channel. It lies at the tip of the big toe, about one leek-leaf’s width from the edge of the toenail, at the three hairs of the big toe. Use a round-pointed needle. Before needling, warm the mouth and recite the incantation: “Truth ◇ reaches the mysterious; the Great Dao is dark and still; the five spirits each take their place; Qi is lacking in the three fields.” After reciting, insert the needle three fen, measuring the cun according to the patient’s own body proportions. Retain it for ten breaths, then withdraw it when Qi moves.

After needling, remain calm for seven days. Do not become heavily intoxicated, sing, or play music, lest the spleen spirit be disturbed and Qi disperse. Do not eat until overfull, lest the abdomen become distended, or eat raw or cold foods, lest they harm Spleen Qi.

To keep the Spleen’s Qi full and its movement unobstructed, do not sit for a long time after eating too much. Avoid foods that are overly sour, as well as raw and cold foods. Choose foods that are sweet and mild in flavor. Mild flavors enter the Stomach and benefit the Qi of the bowels. Mild flavor belongs to Earth; its flavor is light and somewhat less potent than sweetness. Do not sit idly or lie down for long periods. These are all ways to care for the Spleen.

If, among the sexagenary cycles assigned to terrestrial motion, Ding-You is out of its proper position before it is time for the central movement to take charge, the Qi is out of its regular position. Ding and Ren cannot combine; this is also called “failure to hold their positions,” and cannot be called “joining in De.” Thus Yin’s yielding Qi cannot attach to Yang’s firm Qi.

The two sexagenary cycles of Heaven and Earth cannot correspond above and below, and Yin and Yang consequently fall into disorder. This means that the central movement has lost its regular order of correspondence with the year.

Terrestrial motion therefore fails to correspond, and three years later a pestilence will occur. It is also called “Wood pestilence” or “Wind pestilence.” When the epidemic Qi arrives, one must also assess whether it will be mild or severe.

The acupuncture method for treatment is the same as that used for “Wood pestilence.” Whenever Ding and Ren fail to hold their positions above and below, the same acupuncture method is used.

For example, in the year Wu-Shen, firm and yielding Qi fail to hold their positions. Wu combines with Gui; among the two sexagenary cycles of Heaven and Earth, Wu-Shen should combine with Gui-Hai. If Gui-Hai below reaches its earthly position and takes charge of terrestrial motion, while Wu-Shen above passes beyond Ding-Wei, then the celestial influence has not yet withdrawn but circulates again. The positions are therefore lost, and Wu and Gui cannot combine.

The combination of Wu and Gui belongs to Fire movement, but Wu is a Yang year, so this is not a case of Fire movement being excessive. Wu fails to take charge in the regular way, and Gui alone takes charge. It is therefore not excessive; instead, it is controlled by Water Qi.

Yang’s firm Qi is lost above, while Yin’s yielding Qi takes charge alone, so the climate becomes irregular and pathogenic Qi intrudes. Water movement fails to hold its position above, and the central and lower movements are also deficient. Thus the celestial influence is weak, while terrestrial motion continues to preside. Fire movement appears in the center, and Water Qi comes to invade it; this is therefore called “pathogenic interference.”

The various Qi alternate in their movement and shift their positions, with discrepancies ranging from slight to severe.

The movement of the celestial seasons may go awry in different degrees, yet it can still be calculated according to the relevant principles. The key is to observe and conform to the “numerical measures” used to calculate the seasons.

Before a moment of correspondence arrives, the pitches will show a corresponding sign. Here, the reference is to the Fire phase, which belongs to the pitch zhi. Both sets of pitch standards—used in antiquity to determine musical tones and calculate the movement of Qi—must be tested against the two zhi pitches, shaozhi and taizhi, to see whether they sound alike.

If the movement of the seasons becomes disordered in this way, a Fire epidemic will occur within three years. If it comes quickly, it will appear in the gengxu year; if more slowly, it will occur in the xinhai year. At that time, one should needle Feishu, the back-shu point associated with the lungs and their Qi.

Feishu is below the spinous process of the third thoracic vertebra, one and a half cun to either side. A pulse can be felt when the point is pressed. Use a round-pointed, sharp-edged needle. First warm the mouth, then press the point with the hand before inserting the needle. As you needle, recite the incantation: “True and false contend; Qi pours into the Original Spirit; the Emperor’s talisman returns to its source; the position accords with its kin.” Recite it three times, then insert the needle two fen. Wait for the arrival of needling Qi, visualizing white Qi gathering beneath the point, then advance the needle one fen. Once you feel the needling Qi arrive, withdraw the needle slowly and press and rub the point with the hand. The scripture says this will bring quick results.

After needling, remain calm for seven days and do not grieve excessively. Grief throws the movement of lung Qi into disorder, and true Qi may then disperse.

The five emotions—joy, anger, grief, pleasure, and fear—must never become excessive. They all disturb the innate true spirit within a person. Therefore, sages dispel restless thoughts in order to preserve the spirit. The spirit can govern the body: when the spirit is settled, the body is preserved and the person is at peace, allowing the Dao to endure.

To strengthen lung Qi, the key is to regulate the breath and keep it measured. Do not gasp for breath, and speak less, avoiding both hurried breathing and excessive speech. In your diet, avoid cold foods and eat less salty food. Above all, avoid excessive grief, joy, and anger, so that cold influences do not damage the lung spirit.

There is no need to pant, but one should still be cautious: do not speak too much or breathe too frequently. Avoid rapid breathing, excessive speech, cold foods, and exposure to cold; especially avoid food that is too salty. Above all, avoid grief and excessive swings of emotion, since cold influences can damage the Lung spirit—the spirit-energy stored in the lungs.

If the annual cycle reaches the earthly Jiazi or Guihai years, Guihai loses the position it should hold; that is, the yielding Qi is displaced. The firm Qi above is displaced as well. This is also called the failure of the Wu and Gui Qi to unite. The annual cycle and the earthly Qi are therefore both weakened, and three years later an epidemic will occur, called a “fire pestilence.”

(“Fire pestilence” and “fire epidemic” refer to the same thing. The methods of acupuncture treatment are all connected as one: the same principle applies to the Wu and Gui years and to the Qi above and below.)

Therefore, calculate the earthly Qi over five years to determine which Qi has failed to hold its position, then apply the corresponding acupuncture methods. “Epidemic” and “pestilence” are different names for disturbances in the firm and yielding Qi above and below; ultimately, they belong to the same category. There are only five acupuncture methods for treating epidemics. They summarize cases in which the Qi governing each direction has failed to hold its position, and ultimately fall under the governance of the Five Phases (Wood, Fire, Earth, Metal, Water).

(The five kinds of pestilence described above all result from disharmony between the Qi of Heaven and Earth. Once transformed into pestilence, they seriously threaten human life. Therefore, one who understands the Qi of the Celestial Origin can master the corresponding methods of acupuncture and save the people.)

The Yellow Emperor’s Inner Classic: Basic Questions, Supplementary Chapters, Volume Two

Textual notes: In the old annual-cycle passage, the Yuan edition reads “therefore”; “not” is “displaced” in the Yuan edition; “cause” is “unite” in both the Yuan and Ming editions; the character “great” may be an interpolation; where a character is missing, the Ming edition reads “Metal”; after “may,” the Yuan edition has a blank space for one character; the character “bone” may instead be “back, therefore.” Several other textual notes are repeated.

The Yellow Emperor asked: I have heard that when the five kinds of epidemic disease arise, they spread from one person to another, and the symptoms are alike whether the patient is old or young. How should they be treated so that the disease does not spread?

Qibo replied: The key to preventing contagion is to keep the body’s vital energy strong, so that pathogenic influences cannot enter, and to avoid the pestilential vapors. The “Heavenly Female” refers to the breath: it follows a path as it comes and goes. If one understands its passage in and out, epidemic vapors can be expelled through breathing.

If pathogenic vapors leave through sweat but the person is then treated with purgatives, they may enter the body, invade the brain, and spread through the meridians, causing illness. For example, when someone sneezes, epidemic vapors may pass through the nose into the brain. To keep them from entering through the nose, one can induce a sneeze and expel them with the breath, making transmission less likely.

When epidemic vapors leave through the brain, they can no longer harm the body.

Before entering a room where people have epidemic disease, first picture your heart as bright as the sun. This means keeping vital energy within the body and the spirit anchored at its root, so that epidemic vapors cannot enter.

Before entering a room where an epidemic is spreading, first visualize blue-green Qi emerging from the liver and moving leftward to the East, where it transforms into a forest, like the lush green cypress trees of spring.

Next, visualize white Qi emerging from the lungs and moving rightward to the West, where it transforms into weapons and armor, like bright, sharp swords.

Next, visualize red Qi emerging from the heart and rising toward the South, where it transforms into bright flames, like fiercely burning firelight.

Next, visualize black Qi emerging from the kidneys and descending toward the North, where it transforms into water, like black waves.

Finally, visualize yellow Qi emerging from the spleen and remaining in the center, where it transforms into earth, like the yellow ground.

Once the five kinds of Qi are in place and protect the body, visualize a radiance as bright as the stars of the Northern Dipper above your head. Only then may you enter the room where the epidemic is spreading. In other words, let upright Qi reside at the center of the body so that harmful epidemic influences cannot intrude.

There is another method: on the day of the spring equinox, before sunrise, take medicine to induce vomiting. Take polygala root with its woody core removed, decoct it in water, drink two cups, and then induce vomiting. It is said that this prevents infection by epidemic disease.

There is another method: after the Solar Term of Rain Water, use medicine to induce sweating, then bathe three times in succession. A commentary says that if the sweat smells foul, you will not contract epidemic disease.

There is also a recipe for a Small Golden Elixir: cinnabar (two liang), water-ground realgar (one liang), leaf orpiment (one liang), and purple gold (half a liang), ground into a fine powder.

Put the ingredients together in a small container for holding and firing medicines, and seal its outer layer. Dig a pit one chi deep, tamp down the earth, and fire it with twenty jin of fuel for seven consecutive days, keeping the fire at twenty jin throughout. After it has cooled for seven days, take it out. The next day, open the container, then bury the medicine in the earth for seven days.

A commentary adds that it may also be fired in a furnace without treating it with medicines, using twenty jin of fuel continuously for seven days and keeping the fire at twenty jin throughout.

Observe it after it has been refrigerated for seven days. Remove the container the next day, then bury the medicine underground for seven days. (Choose an auspicious place for the burial.)

Take it out on a suitable day and grind it for three days. Then make it into pills with refined white honey, each about the size of a parasol tree seed. Each day, face east, draw in one breath of sunlight, and swallow one pill with ice water, letting your breathing settle before swallowing. After taking ten pills, you will be protected from epidemic illness.

The Yellow Emperor asked, “When a person grows weak, the spirit and Qi drift from their proper place and can no longer guard the body. This allows ghosts and spirits to intrude from outside, bringing an early death. How can we preserve true Qi? Please teach me the methods of acupuncture.”

Qibo bowed twice and said, “That is a profound question. When the spirit and Qi leave their proper place and cease to guard the body, a person may not die at once, even though they remain in the body. But if pathogenic Qi intrudes, it may shorten their life. (Before pathogenic Qi enters, a person may show no signs of illness; as it is about to enter, they may also die suddenly.)

“For example, when the Jueyin channel fails to guard the body and the Qi of Heaven and Earth is also weak, the person’s Liver Qi becomes weak and is further affected by this weakness in the Qi of Heaven and Earth. The inside and outside are then both deficient, and the Hun spirit drifts upward. (Weak Liver Qi and weak Qi from Heaven and Earth do not necessarily cause immediate death. But if pathogenic Qi intrudes as well, life may be shortened. Before it enters, a person may show no signs of illness; as it is about to enter, they may also die suddenly.)

“If the Liver Qi and the Qi of Heaven and Earth are weak, and sweating in the Liver region further depletes the person, this creates threefold deficiency. The spirit and Qi then scatter and drift upward. The Lord of Wuying on the left—one of the Daoist guardian spirits—can no longer descend to protect the person. The spirit light cannot gather, and the White Corpse Ghost arrives, causing sudden death.

“If pathogenic Qi intrudes into the great Qi but the body still has life in it, acupuncture can be used to save the person. (If the eyes still have a glimmer of spirit, the limbs are cold but the chest and abdomen remain warm, there is no saliva or foam in the mouth, and the tongue has not curled up, this is not a Jue condition but is called ‘Corpse Jue’; the person can still be revived.)

“Needle along the course of the Foot Shaoyang channel.”

The points traversed by the Foot Shaoyang channel include Qiuxu, located in the hollow just below and toward the front of the outer ankle, five cun from Linqi. It is the Yuan-Source point of the Foot Shaoyang channel, where the channel’s Qi gathers and which can be used to regulate disorders of that channel. For needling, use a filiform needle. First warm it against the patient’s body until it is warm to the touch. Press the point with the left hand and recite: “The Supreme Primordial Lord always dwells on his left; subdue the Three Hun Souls.” Recite this three times, then call the Three Hun Souls by name—Shuangling, Taiguang, and Youjing—and recite their names three times. Next, visualize a green dragon beneath the point, insert the needle three fen, and breathe slowly three times while the needle is retained. Then withdraw it slowly, while someone presses down the patient’s breath in the mouth. If rumbling sounds arise in the abdomen, treatment may proceed.

Next, needle Ganshu, located one and a half cun to either side below the ninth vertebra of the back. Warm a filiform needle against the body, press the point with the left hand, and recite: “Lord of the Great Subtlety, Primordial Essence, subdue the Hun Soul; let the true source reach the root and enter the azure clouds.” Then call the Three Hun Souls by name as before, reciting their names three times. Insert the needle three fen and breathe three times while retaining it. Advance it another two fen and again breathe three times while retaining it. Then withdraw it to three fen, retain it for one breath, and slowly remove it. This can turn the Qi back and restore the patient’s vitality.

When a person’s Heart Qi is weak and the sovereign and ministerial Fire phases governing the heavens have both failed to keep their proper positions, the person is affected by the combined force of the “Three Vacuities.” This may also occur when Heart sweat leaks outward, causing the Hun and Po spirits to move upward against their proper course and enter the Mudball Palace, the cultivation center in the middle of the head.

If this is compounded by deficient Fire Qi and an attack by the Black Corpse demon, the illness may cause sudden death. If the onset has lasted less than one shichen, treatment may still be possible. Even if the limbs are cold and breathing has ceased, the patient may still be saved so long as the complexion has not changed and the tongue has not stiffened. Needling may also be performed if the light in the eyes has not faded.

Needles may be inserted at points along the Foot Yangming channel.

Here this refers to Yangchi, a point in the hollow on the back of the wrist. It is the source point of the Hand Shaoyang channel, where the channel’s Qi gathers and which can be used to regulate and treat conditions of that channel. Use a fine needle. First warm the body, then press the point with your hand and recite: “Great One Sovereign, chief spirit of the Niwan; let the elixir be free of dark Qi and return to its true state.” Recite this three times while imagining a red phoenix resting beneath the point. Insert the needle two fen and retain it for seven breaths; advance it one fen and retain it for three breaths; then withdraw it and retain it for one breath. Finally, slowly press and rub the point with your hand. The text says this can restore the person.

Next, needle the Xinshu point.

Xinshu is located below the fifth thoracic vertebra, one and a half cun to either side. Use a fine needle. First warm the body, then press the point with your hand and recite: “The elixir chamber guards the numinous; the Five Emperors rise into the blue; yang harmony spreads through the body and returns to the Yellow Court.” Recite this three times, then insert the needle seven fen and retain it for one breath. Advance it one fen and retain it for one breath; withdraw it to a depth of two fen and retain it for one breath. Then slowly remove the needle and press and rub the point with your hand.

If someone has a spleen disorder and Heaven’s Taiyin influence is out of balance, the person may be struck by the evil force known as the “Three Vacuities.”

“Double Vacuity” means that the Spleen Qi is weak and there is sweating. Combined with two other forms of weakness, this is called the “Three Vacuities.” The wisdom spirit and the intention spirit have both wandered away from the body, which is why this is called “losing their guard.”

If Earth Qi is also deficient at this time, the Green Corpse demon may invade the body and cause sudden death.

If less than one shichen has passed, there may still be a chance to save the person. Even if the limbs are cold, the person may be revived if the body and lips remain warm. A condition in which there is no saliva in the mouth is called “corpse reversal.”

Needles may be inserted at points along the Foot Yangming channel.

Chongyang, a point on the Foot Yangming channel, lies over the artery between the two bones on the top of the foot, three cun from Xiangu. It is the source point of the Foot Yangming channel, an important point where channel Qi gathers. When needling with a filiform needle, first keep the person’s body warm, then press the point with the hand and recite the incantation: “Ever present in the Hun Court, at the beginning clear and greatly tranquil; primordial harmony spreads Qi; the Six Jia and the True One.” After reciting it three times, visualize the Yellow Court—the place within the body where the spirits and Qi reside in Daoist inner cultivation—beneath the point. Insert the needle three fen and retain it for three breaths. Then advance it two fen and retain it for one breath. Slowly withdraw the needle, pressing the site with the hand.

Next, needle Pishu, the back-shu point corresponding to the Spleen. It lies below the eleventh vertebra, one and a half cun to either side. When using a filiform needle, press the point with the hand and recite the incantation: “The Great Beginning established its place and governs the origin of Kun; the true Qi of the Yellow Court returns, circulating in full.” Recite it three times, insert the needle three fen, and retain it for two breaths. Then advance it two fen, guide the needle so that Qi arrives, and slowly withdraw it.

When a person with lung disease encounters Yangming governing Heaven—a concept in the traditional Chinese medicine theory of cyclical influences, in which Yangming Qi governs the season—they should first protect their upright Qi. If they are also exposed to an external pathogen, this creates the “Three Deficiencies.”

The “Three Deficiencies” are the person’s own weakness, unfavorable seasonal influences, and sweating caused by lung disease: three sources of depletion that compound one another. The Hun Qi then floats upward and scatters, which is why this is called “losing its anchor.”

In addition, when Metal Qi is deficient in the cyclical influences, the Red Corpse Ghost—a harmful spirit said in the text to cause illness—may invade the body and cause sudden death.

If treatment is given within one shichen, or two-hour period, needling may still save the patient even if they have stopped breathing and their hands and feet are cold, provided the chest and abdomen remain warm, the nose is slightly warm, the light in the eyes has not yet faded, there is no saliva in the mouth, and the tongue has not curled up.

The Hegu point on the Hand Yangming channel may be needled. Hegu lies between the thumb and index finger and is the source point of the Hand Yangming channel. When using a filiform needle, first warm the patient’s body, then…

The point through which the Qi of the Foot Yangming channel passes is Hegu, located between the thumb and index finger. It is also the Yuan Source point of the Hand Yangming channel, an important point where channel Qi gathers and enters or leaves. Use a filiform needle. First warm the needle, then press the point with your hand and recite the incantation: “Pure blue Qi, complete and true; the Emperor’s talisman, the origin of the sun; let the seven souls return to the right, and now be restored to the original field.” Recite it three times, while imagining white Qi gathering beneath the point. Insert the needle three fen and retain it for three breaths. Then advance it to five fen and retain it for three breaths. Next withdraw it by one fen and retain it for one breath. Slowly remove the needle, then press the point with your hand to restore it.

Next, needle the Feishu point.

Feishu is located on the back, below the third thoracic vertebra, one and a half cun to either side. Use a filiform needle. First warm the needle, then press the point with your hand and recite the incantation: “Perfected One of the Left Origin, guest of the Qi of the Six Directions; Heaven’s talisman and the Emperor’s power, come and enter its office.” Recite it three times. Insert the needle one and a half cun and retain it for three breaths. Then advance it by two fen and retain it for one breath. Slowly remove the needle, then press the point with your hand.

If someone has kidney disease and the Taiyang fails to govern Heaven—meaning that the Qi of Taiyang Cold Water is irregular in a year when it should govern Heaven—they may be affected by pathogenic Qi and develop what is called “threefold deficiency.”

“Threefold deficiency” refers to a person’s own weakness, unfavorable seasonal conditions, and sweating caused by kidney disease. According to this account, the kidney spirit then withdraws and wanders to the Yellow Court, the Daoist dwelling place of the spirits within the body. Though it has not left the body, its radiance can no longer gather; this is therefore called “losing its post.”

If this also occurs in a year when the Water phase is insufficient, the Yellow Corpse Demon, a disease-causing entity described in the scripture, may invade the person’s vital Qi and drain their spirit and soul, potentially causing sudden death.

If breathing has stopped and the limbs are cold, but the heart and abdomen remain slightly warm, the eyes have not changed in appearance, the lips and tongue have not changed color, and there is no saliva in the mouth, the person may still be saved, according to the scripture.

The point through which the Qi of the Foot Taiyang channel passes may be needled.

The Foot Taiyang channel passes through Jinggu (BL64). Jinggu lies in a hollow beneath the large bone on the outer side of the foot, at the boundary between the red and white flesh. It is also the source point of the Foot Taiyang channel. Before inserting the filiform needle, keep the patient warm, then press the point with your hand and recite the incantation: “Primordial Yang nurtures the infant; the Five Elders and the perfected ones; the mysterious radiance of the Niwan; replenish essence and preserve it forever.” At the same time, imagine black Qi beneath the point. Insert the needle about two and a half fen and leave it in place for three breaths. Advance it to three fen and leave it for one breath. Then withdraw it slowly and press the needle hole with your hand.

Needle the shu point of the Foot Shaoyang channel. This point lies below the tenth vertebra on the back, one and a half cun to either side of the spine. First insert the filiform needle about two and a half fen and leave it in place for three breaths. Advance it to three fen and leave it for one breath. Then withdraw it slowly and press the needle hole with your hand.

Needle the shu point of the Foot Shaoyang channel. This point lies below the tenth vertebra on the back, one and a half cun to either side of the spine. Before inserting the filiform needle, press the point with your hand and recite the incantation: “Heaven’s mystery and the sun’s essence; the Great Harmony and Kun’s numinous power; true primordial essence guarded within; hold fast and enter the beginning of blue.” After reciting it three times, insert the needle three fen and leave it in place for three breaths. Advance it to five fen and leave it for three breaths. Then withdraw it slowly and press the needle hole with your hand.

The Yellow Emperor asked, “The twelve viscera work together in their functions. If the spirits lose their proper places, so that their vitality is no longer full and complete, they may be assailed by evil Qi. Acupuncture can be used to treat this. I would like to hear its essential principles.”

(This describes the acupuncture method used when the Five Spirits fail to remain in their proper places, and also discusses the wondrous functions of the twelve spirits.)

After bowing twice, Qibo replied, “Your question is comprehensive and touches on the utmost principle and the root of the Dao. Were you not a sagely and enlightened ruler, how could you investigate such origins? This concerns Qi and spirit joining with the Dao and responding to Heaven.”

(The movement of a person’s Qi corresponds to the Qi that governs the heavens, and the person’s spirit and Qi also respond to one another. This relationship changes as they wax and wane.)

The heart is the official of the sovereign, and from it come spiritual illumination.

(The heart governs all the body’s activities, so it is called the official of the sovereign. The spirit resides in the heart, and the heart’s flourishing or decline also affects the spirit’s state.)

The heart is the official of the sovereign, and from it come spiritual illumination.

The Heart governs a person’s mental and spiritual activity, so it is called the official of the sovereign. The Heart depends on the body for its form, and the spirit can exist only by dwelling within it; thus, the Heart is the spirit’s abode. If the true Heart fails to carry out its duties and becomes empty within, the spirit cannot remain settled in its place. It seems to wander aimlessly among the organs, the five spirits cannot find peace, and the body consequently becomes weak.

One may needle the Yuan point of the Hand Shaoyin channel, a point where the channel Qi gathers and which can be used to regulate the channel.

The Yuan point of the Hand Shaoyin channel is the Duigu point, located in the hollow at the end of the Duigu bone on the back of the wrist. It is also called Zhongdu. Use a long needle and warm it with the heat of the breath from the mouth. Insert it three fen and retain it for three breaths. Then advance it one fen and retain it for one breath. Slowly withdraw the needle, press the needle opening with the hand, and let the person recover.

The Lung is the official who assists the sovereign; it directs the body’s regulatory functions.

The Lung is positioned high in the body, so it is likened to the official who assists the sovereign. It governs the circulation of nutritive Qi and defensive Qi, which nourish the body and protect its exterior; the body’s regulatory functions arise from this. Breathing should be naturally steady. If one talks excessively without restraint, drinks cold liquids and is exposed to cold, or suffers excessive grief, the Lung spirit cannot remain settled in its place, and the body becomes weak.

One may needle the Yuan point of the Hand Taiyin channel.

The Yuan point of the Lung channel is the Taiyuan point, located in the hollow between the large tendons behind the wrist, about one and a half cun from the wrist. It is a point along the Hand Taiyin channel. Use a long needle and warm it with the heat of the breath from the mouth. Press the point, insert the needle three body cun, and retain it for three breaths. Once Qi is felt beneath the needle, slowly withdraw it, then press the needle opening with the hand.

The Liver is the official of the general; it directs planning and deliberation.

The Liver has the qualities of courage and decisiveness, so it is called the general. When needling, first press the point, then insert the needle three body cun and retain it for three breaths. Once Qi is felt beneath the needle, slowly withdraw it and press the needle opening with the hand.

The Liver is the official of the general; it directs planning and deliberation.

The liver governs planning and deliberation, so it is likened to a general. It can act decisively, and its plans take shape before events occur. If someone suddenly becomes angry, Qi surges upward and is then obstructed as Qi activity converges, the spirit may lose its protection and its radiance may fail to gather. In this case, acupuncture can be applied as described earlier to help settle the spirit and Qi.

The source point of the Foot Jueyin channel may be needled.

The source point of the Foot Jueyin channel is Taichong, located in a hollow about two cun behind the base joint of the big toe. It is a point along the Liver channel where Qi and blood pass through and gather. Use a long needle, first warming it in the mouth, then press the point with the hand. Insert the needle three fen and retain it for three breaths; advance it another two fen and retain it for two breaths. Then withdraw it slowly and massage the area around the needle site with the hand.

The gallbladder is the “official of central correctness” and governs decision-making.

The gallbladder is firm, upright, and bold, which is why it is called the official of central correctness. Its judgments are direct and free of hesitation, enabling it to make decisions. If Qi activity stirs and someone suddenly becomes angry, and the anger persists, Qi surges upward and cannot return to its proper place. This disrupts the gallbladder’s capacity to make decisions and may develop into diaphragm obstruction—a type of symptom involving impaired Qi movement between the chest and diaphragm and difficulty swallowing. It may also prevent the spirit’s radiance from gathering. Even if pathogenic Qi has not yet intruded, acupuncture may be used in advance.

The source point of the Foot Shaoyang channel may be needled.

The source point of the Foot Shaoyang channel is Qiuxu, located in the hollow below the outer ankle, five cun behind Linqi. It is a point along the Foot Shaoyang channel. Use a long needle, first warming it in the mouth, then press the point with the left hand. Insert the needle about three fen and retain it for three breaths; advance it to five fen and retain it for two breaths. Then withdraw it slowly and massage the area around the needle site with the hand.

The Center of the Chest is the “official of the minister and envoy,” from which feelings of joy emerge.

The area at the center of the chest between the breasts is the sea of Qi in the chest and the dwelling place of the Hand Jueyin Heart Protector channel. Here it corresponds to the position of ministerial fire, so it is called the “ministerial envoy,” and governs joy. When the heart is stirred by emotions such as alarm, joy, anger, worry, or fear, the spirit and Qi may lose their place of rest, leaving a person dazed, as if bereft of awareness, and unable to concentrate. When pathogenic Qi takes advantage of this weakness and intrudes, acupuncture can help restore calm and harmony to the spirit.

One may needle a point where the Qi and blood of the Heart Protector channel flow.

This is the Laogong point, located at the center of the palm where the artery pulses. It is the transport point of the Hand Jueyin Heart Protector channel, where the channel’s Qi flows. Use a long needle, first warming it in the mouth. Then press the point with the left hand and insert the needle about three fen, an ancient unit of acupuncture depth. Retain it for the time of two breaths, then withdraw it slowly and press and rub the needle hole with the hand.

One may needle a point where the Qi and blood of the Heart Protector channel flow.

The Spleen is the “official of counsel,” from which wisdom spreads throughout.

What the heart retains in memory is called “intention”; the judgments and reflections that arise from intention are called “wisdom.” Wisdom can know all things throughout, and all of it comes from intention and wisdom. That is why it is said to spread throughout. If intention becomes fixated on something, and desire gives rise to further thoughts, the spirit of the heart grows endlessly weary. When wisdom is caught up in certain thoughts, the spirit and Qi wander and lose their grounding, and the spirit becomes difficult to gather. This condition can be treated in advance.

One may needle the Spleen channel’s source point, where the channel’s Qi gathers and connects with the organs.

The Spleen channel’s source point lies on the inner side of the foot, in the hollow below the navicular bone, along the course of the Foot Taiyin Spleen channel. Use a long needle, first warming it in the mouth. Then press the point with the left hand and insert the needle three fen, retaining it for the time of five breaths. Advance it to a depth of three fen and retain it for another five breaths. Then withdraw it slowly and press the needle hole with the hand.

The Stomach is the “official of the granaries,” which stores food and drink; the Five Flavors—the tastes of different foods—come from it.

The Stomach governs the receipt of the five grains, so it is called the “official of the granaries,” the organ that stores food. Stomach Qi nourishes the body throughout, which is why the five flavors are said to emerge from the Stomach. Sweating after eating too much, or engaging in sexual activity after a full meal, can both cause Qi to stagnate and flow poorly, disrupting the spirit’s normal ability to remain settled. Before pathogenic influences have entered, treatment can be given in advance to preserve the body.

The Stomach’s source point can be needled. A source point is an acupuncture point where an organ’s source Qi gathers.

The Stomach’s source point is Chongyang, on the top of the foot, about five fen by proportional body measurement, over the artery between the two bones, five cun from Xiangu. It lies along the Foot Yangming channel. Use a long needle, warming it in the mouth first. Press the point with the left hand, insert the needle three fen, and retain it for three breaths. Then advance it another two fen and withdraw it slowly. Finally, press and rub the needle site with the hand.

The Large Intestine is the organ that serves as a passageway, transporting and expelling food residue after it has been transformed.

“Transporting the Way” here means a passageway for conveying impure matter; “transformation” refers to food changing form inside the body. The Large Intestine is therefore called the “official of transmission,” responsible for transformation and expulsion. If a man develops the disorder called “fan,” he loses the normal function of his organs. Since this is not caused by pathogenic influence, acupuncture can be used to treat it and restore the abnormal state to normal.

The Large Intestine’s source point can be needled.

The Large Intestine’s source point is Hegu, in the hollow between the bones of the thumb and index finger on the back of the hand. It lies along the Hand Yangming channel. Use a long needle, warming it in the mouth first. Insert it two fen and retain it for three fen; then advance it another two fen, retain it for one breath, and withdraw it slowly.

The Small Intestine is the organ that receives and holds food, digesting and transforming it before discharging it. It carries on the Stomach’s function: it receives food residue, digests it further, and transports it to the Large Intestine. It is therefore called the “official that receives and holds,” the organ that takes in food, and is responsible for transforming it. When reception and transformation become abnormal, causing the spirit to lose its normal ability to remain settled, acupuncture can be used to treat the condition and preserve the body.

The Small Intestine’s source point can be needled.

The source point of the Small Intestine meridian is Wangu, located on the outer side of the wrist, in the hollow below the prominent bone at the front of the wrist. It is where the Hand Taiyang meridian passes. Use a long needle. First warm the needle in your mouth, then press the point with your left hand. Insert the needle three fen and leave it in place for three breaths. Advance it another two fen and leave it for one breath, then withdraw it slowly. Finally, press and rub the area around the needle hole with your hand.

The Kidneys govern strength and the ability to move, and human skill also comes from them. When Kidney Qi is strong, a person can carry out many functions; the formation and transformation of the body are also related to the Kidneys. The classic says that in women this is emphasized as “skill,” while in men it is emphasized as “strength in action.” Excessive exertion, or transgressions on the “Three Origins and Eight Correct Alignments” (specific celestial times and days), may cause a person’s spirit and Qi to become unsettled. Needling the Kidney meridian’s source point in advance can therefore protect the body’s Jing and Qi.

Needle the Kidney source point. The source point of the Kidney meridian is Taixi, located in the hollow below the inner ankle and in front of the heel bone. It is where the Foot Shaoyin meridian passes. Use a long needle and warm it first, then press the point with your left hand. Insert the needle three fen and leave it in place for one breath. Advance it another fen and leave it for one breath, then withdraw it slowly and press the area around the needle hole with your hand.

The Triple Burner governs the regulation of the water pathways, directing the movement of fluids through the body. It guides the Qi of Yin and Yang and clears obstructions. Before needling, warm the needle and press the point with your left hand. Insert the needle three fen and leave it in place for one breath, then advance it another fen and leave it for one breath. Withdraw it slowly and press the area around the needle hole with your hand.

By guiding the Yin-Yang Qi and opening what is obstructed, the Three Burners (Sanjiao) regulate the movement of fluids, allowing the waterways to flow freely. Their function is like that of four great rivers emptying into the sea: the streams flow into the sea, each following its original course. For this reason, they are called the “Four Rivers.”

As the Three Burners open the waterways, Jing-Qi and fluids move without mixing. This is why the Three Burners are divided into the upper, middle, and lower burners. The upper burner governs intake, not discharge; if something that should not be taken in enters, it too fails to perform its proper function. The middle burner governs the ripening and breaking down of food and drink—that is, digestion. At times, emotions may arise within the heart, or changes may suddenly occur without being deliberately initiated. This is called “solitary movement,” and at such times Shen-Qi may lose its proper place. The lower burner governs discharge, not intake; if what should be discharged is not released, or something that should not be taken in enters, Shen-Qi may likewise lose its proper place.

Needle the source point of the Three Burners.

The source point of the Three Burners is Yangchi, in the hollow on the back of the wrist, where the Hand Shaoyang channel passes. Use a long needle, warming it first in the mouth, then press the point with the left hand. Insert the needle three fen and pause for three breaths; advance it one fen and pause for one breath; then withdraw it slowly and gently press the needle hole with the hand.

The Bladder is the “official of the waterways,” governing the gathering and discharge of fluids, and storing essence. Only through transformation by Qi can fluids be discharged.

The Bladder lies in the lower abdomen and has an internal cavity, which is why it is called the “storehouse official”; it can also store essence. When it receives Qi from the Sea of Qi—the Qi associated with the movement of the body’s original Qi—transformation by Qi begins, and urine can be discharged. If the Sea of Qi is deficient, there may be a feeling of distention and dull pain, with difficulty urinating. Hence the saying, “When Qi transforms, it can be discharged.” If a person has difficulty passing stool and Qi gathers and descends into the Bladder, essence may leak and the movement of Qi may become obstructed. When the waterways cannot flow freely, Shen-Qi may also lose its proper place. Only those who understand how to care for the body through needling can grasp the subtlety of this method.

Needle the source point of the Bladder.

The source point of the Bladder is Jinggu, in the hollow below the large bone on the outer side of the foot, at the boundary between the red and white flesh, where the Foot Taiyang channel passes. Use a long needle, and you will be able to appreciate the subtlety of this method.

Needle the Jinggu point, the source point of the Foot Taiyang Bladder Channel, located in the hollow below the prominent bone on the outer side of the foot, at the junction of the red and white flesh. Use a long needle and warm it first. Press the point with the left hand, then insert the needle three fen and leave it in place for three breaths. Next, advance it two fen farther and leave it for another three breaths. Finally, withdraw the needle slowly and press the puncture site with the hand.

The twelve officials—the body’s twelve major organs and their functions—must not become disharmonized. If they do, calamity follows. The radiance of a person’s Shen (spirit) can no longer gather and remain in place, and pathogenic Qi may intrude, injuring the innate reality of life. Therefore, acupuncture should be performed first to preserve that reality.

Acupuncture thus aims to preserve the spirit and nurture innate reality; it also offers a path of cultivating the true. It is not merely a treatment for illness, but a way to cultivate body and mind and harmonize the spirit. Shen governs the nurturing of life, so it must first be settled and nourished.

The Dao (the Way) prizes constancy. Nourish the spirit and strengthen the root, so that Jing (essence) and Qi (vital energy) do not scatter and the mind’s intent does not divide. The body’s three treasures are Shen, Qi, and Jing. If any one of them is not kept secure, all three will suffer. When the three are kept together, this is called primordial harmony, an inner state of balance and union.

Even when Shen has not left the body, that alone does not mean innate reality has been preserved. If Shen leaves the body, the person dies. But even while Shen remains within, if it does not stay settled in its proper place, innate reality has not truly been preserved.

If a person’s Shen cannot remain secure, they cannot reach the utmost reality, the highest state of innate truth. When Shen is unsettled, its radiance is diminished. Thus, one must preserve innate reality and gather and nourish the radiance of Shen in order to cultivate the true. Only by preventing true Qi from being depleted can one be said to understand the cultivation of the Dao.

The key to the way of utmost reality lies in the Celestial Mystery, the profound and subtle Dao of Heaven.

In the womb, a person first connects with the “breath of the Celestial Mystery.” This breath is called the “Mysterious Female” (the portal of breathing deep within life), and is also known as the “Gate of the Valley Spirit,” “Shenyi,” “the Earth Gate in the upper realm,” “the Mountain at the Center of Humanity,” “the Gate of Embryonic Breathing,” or “the key to communicating with Heaven.” If a person can let go of cravings and desires, calm joy and anger, let their actions follow this breath of the Celestial Mystery, and put an end to distracting thoughts, they will be as they were in the womb. This is called “returning to the Celestial Breath.” In this way, one can return to life’s foundation, enter stillness, return to the Great Beginning, and restore the method of cultivating the original fetal breath.

To keep Shen settled in the Celestial Breath and reenter one’s original source is called “returning to the ancestral source,” that is, returning to life’s foundation.

When a person suffers from various illnesses, having the Shen that guard the different parts of the body enter the breath within the Mystery can preserve the completeness of the true Qi at life’s foundation and allow the Way of Shen to remain settled for a long time.

The Yellow Emperor asked, “I already understand the nine obstructions of the Heavenly Origin, the ways the movement of the seasons can be impeded. What does ‘failing to hold its position’ mean in the account of the meeting of Qi between Heaven and Earth?”

Qibo replied, “The six Qi—Wind, Cold, Summer Heat, Dampness, Dryness, and Fire—rise and descend between Heaven and Earth, each following its own order of movement. At times, a Qi takes up its proper position at the appointed time; at other times, it withdraws from its former position. The relevant patterns of movement are recorded for both above and below. When a Qi that should rise fails to rise, or one that should descend fails to descend, this is called ‘failing to hold its position.’

“The Heavenly Origin Jade Register says that ordinarily three of the six Qi are in Heaven and three are on Earth. One Qi rises into Heaven and becomes the left intermediary Qi; one enters beneath the Earth and becomes the right intermediary Qi. One takes up its proper position as the Qi in charge of Heaven, and another takes up its proper position as the Qi in charge of the Earth. Other Qi withdraw from their positions, becoming, respectively, the left intermediary Qi of Heaven and the right intermediary Qi of Earth. When the meeting of Qi is properly aligned, each Qi arrives at its appointed position on time, and the Qi of Heaven and Earth meet. Change then takes place, allowing the four seasons to proceed in due order. When the Qi of Heaven and Earth do not meet, illness follows.”

Thus, if the Qi lose their proper positions when they meet, the climate changes. Once these changes become abnormal, the four seasons fall out of order, all things lose their stability, and people become ill as a result.

The movement of the six Qi is obstructed when a Qi that should rise cannot rise, one that should descend cannot descend, one that should take up its proper position cannot do so, or one that should occupy a certain place fails to arrive there. In such cases, Heaven and Earth lose their normal patterns of movement, and the people cannot live in peace.

The Yellow Emperor asked again, “Why can rising and descending fail to occur at their appointed times? And how can we recognize changes in the meeting of Qi?”

Qibo replied, “Your question goes to the heart of the matter; you have understood its principle. Changes in the meeting of Qi are precisely the key to the movement of Heaven and Earth.”

Wood Qi seeks to rise but is obstructed by the Celestial Pillar; Fire Qi seeks to rise but is obstructed by the Celestial Canopy; Earth Qi seeks to rise but is obstructed by the Celestial Surge; Metal Qi seeks to rise but is obstructed by the Celestial Brilliance; Water Qi seeks to rise but is obstructed by the Celestial Interior. This is because barriers in the heavens press them down, preventing them from continuing their movement.

Qi may seek to descend but be unable to do so, because it is obstructed and restrained by Earth Qi.

When Wood Qi seeks to descend, it is obstructed by Earth Brightness; Fire Qi by Earth Mystery; Earth Qi by Earth Azure; Metal Qi by Earth Vermilion; and Water Qi by Earth Mound. The nine terrestrial obstructions correspond to celestial phenomena and are forces that restrain the Qi of their own phase. Therefore, Qi cannot descend.

Another possibility is that the Five Phases’ movements (the moving Qi of Wood, Fire, Earth, Metal, and Water) are excessive and arrive earlier than the season. As a result, their transition and movement are obstructed, and they cannot proceed smoothly.

In a yang year, when the Qi of the Five Phases reaches the position governing its season, it is obstructed and restrained by Earth Mound. The nine terrestrial obstructions correspond to celestial phenomena and are forces that restrain the Qi of their own phase. Therefore, Qi cannot descend.

Qi may seek to rise but be unable to do so because it is suppressed by the central movement—the moving Qi that governs the movements of the Five Phases between Heaven and Earth. When Wood Qi rises, it encounters restraint by Metal movement; when Fire Qi rises, by Water movement; when Earth Qi rises, by Wood movement; when Metal Qi rises, by Fire movement; and when Water Qi rises, by Earth movement. In each case, the Five Phases’ movements are excessive and arrive too early, reaching their position before the Qi exchange—the period when the Qi of Heaven and Earth converge. They are therefore suppressed and cannot continue onward.

Qi may also seek to descend but be unable to do so because it is suppressed by the central movement. When the movements of the Five Phases are excessive and arrive too early at the position governed by the central movement, Qi cannot descend smoothly. It is restrained by the central movement and brought to a standstill.

Thus, Qi may seek to rise but be unable to advance, or seek to descend but be unable to move downward. It may also be unable to descend and instead rise toward Heaven. Or both its ascent and descent may be obstructed, leaving it seemingly at a complete standstill.

Some Qi rises but cannot continue upward; some Qi descends but cannot continue downward. Some Qi, blocked as it descends, turns and rises instead, reaching all the way to Heaven. There are also cases in which both ascent and descent are blocked. Considered separately, each of these is an expression of change in the Qi exchange. The changes differ, as do the severity and extent of the resulting harm.

(Thus, the ascent and descent between the upper and lower realms of Heaven and Earth, and the exchange of Qi, can be affected when the Qi of Heaven or Earth is obstructed or overcomes the other. The degree to which the central movement is suppressed varies, and this leads to differences in the severity of illness among the people.)

The Yellow Emperor asked: I wish to understand why Qi in exchange meets, overcomes, and suppresses other Qi, how these changes produce illness among the people, and how the severity of illness varies.

(This is a question about the roots and manifestations of illness caused by changes in Qi.)

Qibo replied: This happens when different Qi meet and overcome one another, causing suppression and stagnation.

(The ascent and descent of the Six Qi are regular patterns described in the classics and the normal state of the Qi exchange. But the Six Qi do not always meet and constrain one another. When they meet and one suppresses the other, stagnation results.)

Thus, in years of Chen and Xu, when Wood Qi rises, it encounters “Heaven’s Pillar” (a celestial direction and climatic manifestation associated with Metal Qi), which suppresses it and prevents it from rising further.

(These are years when the Qi of Taiyang moves into the position governing the climate of Heaven, giving rise to stagnation.)

Thus, in years of Chen and Xu, when Wood Qi rises, it encounters “Heaven’s Pillar,” which suppresses it and prevents it from rising further.

(In years of Chen and Xu, Taiyang governs Heaven—that is, it governs the climate of the year. Jueyin Qi was originally in the position of Earth and occupied the right interval; in these years it rises into Heaven and becomes the Qi of the left interval. It then encounters the Qi governing Heaven. By calculating the positions of the Qi, it reaches the position of Heaven’s Pillar and is blocked. Wood Qi seeks to rise, but the Metal Qi governing Heaven overcomes Wood Qi and prevents it from advancing.)

If it also encounters a Geng-Xu year, Metal movement arrives ahead of its proper season, and the Metal Qi of the central movement suppresses Wood Qi, suddenly preventing it from rising.

(A Geng year belongs to Metal movement, whose Qi arrives ahead of its proper season. The transition begins on the thirteenth day after the next phase begins. Wood Qi is ready to rise, but Metal movement suppresses it.)

As Wood movement rises, Metal Qi suppresses it.

(Sometimes the obstruction comes from Heaven’s Pillar above; sometimes the Metal Qi of the central movement suppresses it.)

When the rise of Wood Qi is blocked, cool Qi arises and Wind Qi weakens. The killing force of autumn appears in spring, and dew and frost descend, causing plants and trees to wither. People become prone to early outbreaks of epidemic febrile illness, dryness of the throat, swelling of the limbs, and pain in the joints of the limbs. After the stagnation persists for a time, change occurs.

(Only when Wood Qi rises to the position of the left interval on its appointed day does the stagnant Qi break out.)

The violent wind snaps trees, toppling them with a chaotic crash. People may suddenly suffer windstroke, with localized numbness, obstruction, and pain; plants and trees may also wither. Epidemics may break out early, causing fever, a dry throat, swelling in the limbs, and joint pain. Over time, the pathogenic influence becomes lodged and does not resolve.

(The illness only breaks out on the day when the left-intervening qi takes charge in the seasonal cycle.)

The violent wind snaps trees, toppling them with a chaotic crash. People may suddenly suffer windstroke, with localized numbness, obstruction, and pain, and may even lose sensation in their hands and feet.

(When greenish dust-like qi appears, wind-related epidemic illness breaks out. Patients may arch backward, with their limbs stiff and rigid. Treatment should open the three Shu points: the three acupuncture points through which qi and blood connect with the internal organs.)

Thus, in the years of Si and Hai, Sovereign Fire (Shaoyin Sovereign Fire among the Six Qi) should ascend to heaven and take charge, but is obstructed by Tianpeng (a stellar spirit associated with Water qi, or the deity governing that qi), and cannot rise smoothly.

(Sovereign Fire governs on earth for three years. In the years of Si and Hai, Shaoyin qi ascends to heaven and becomes the left-intervening qi; this can be inferred from the account here. Tianpeng governs Water. The Tianyuan Ce uses a method of calculating and subtracting to derive the position of the Kan Palace. When its value falls in that palace, this indicates that Tianpeng’s Water qi is obstructing and taking charge, so Water qi prevails.)

When Wood qi of Jueyin also shifts into its proper position, Shaoyin Sovereign Fire is unable to ascend to heaven. The qi of the Water phase enters and suppresses the Sovereign Fire that is trying to rise.

(In other words, Tianpeng’s Water qi prevails, or the qi of the Water phase suppresses Sovereign Fire.)

When Sovereign Fire cannot ascend, clear, cold qi appears again, and cold may set in at any time from morning until night. Although latent Yang heat is present within the people, it gives rise to vexing heat, fearful agitation of the heart and spirit, and palpitations; alternating bouts of cold and heat follow. In time, this develops into stagnation.

(If this persists for two periods of seven days—that is, fourteen days—without subsiding, it counts as prolonged.)

Sudden high fever may then develop. Red Wind (the qi of red-colored wind) causes swelling and visual obstructions, and transforms into epidemic illness; warm pestilence may also break out.

(The illness breaks out on the day when the left-intervening qi takes charge in the seasonal cycle. Patients may have latent heat within, vexation in the heart, obstruction and pain, and cold extremities. In severe cases, they may also bleed.)

When red miasma transforms into a Fire epidemic, patients are usually restless and thirsty. If their thirst is severe, treatment that drains and disperses the condition can halt its progress. Thus, in the years of Zi and Wu, Taiyin (damp Earth among the Six Qi) ascends to heaven and takes charge, but is obstructed by Tianchong and cannot rise smoothly.

After Taiyin has completed its second year of circulation in the terrestrial arrangement, it rises to Heaven and becomes the Qi of the left interval of Shaoyin. This can be determined in advance. But if the Qi dynamics in Heaven are obstructed, the date of its ascent cannot be predicted in advance. When Heaven’s timing is blocked, Earth Qi cannot rise to Heaven at once; hence the ascent does not take place on schedule.

For example, in a Renzi year, Wood movement arrives earlier than usual because the Wood Qi within the central movement is constrained. The date of its ascent therefore cannot be predicted in advance. If Heaven’s timing is blocked at the same time, Earth Qi cannot rise to Heaven at once, and the ascent does not take place on schedule.

Wood Qi usually rises to Heaven on the day of Great Cold. If it arrives thirteen days early, it may encounter mutual suppression among the Wood Qi. The more severely Earth Qi is suppressed, the deeper the associated illnesses become.

When ascent to Heaven is delayed, winds and sand sweep about, dust often darkens the sky, and the dampness of rainwater cannot transform and spread as it should. People may suffer from wind-induced reversal, surging phlegm and saliva, paralysis affecting one side of the body and preventing movement, abdominal distension, and other conditions. These become stagnated, linger for a long time, and remain hidden without dispersing.

The “failure to advance in ascent” described here means that the Qi dynamics remain delayed and have still not risen to Heaven after ten days. If the delay lasts longer, the conditions described above will appear.

At such times, yellow dust fills the air and may also bring on an epidemic.

This is a major epidemic caused by the Qi governing the interval between the Qi in charge of Heaven and the Qi in charge of Earth becoming congested above.

People may die prematurely, and their faces, limbs, and abdomens may turn yellow, with jaundice, distension, and obstruction. Dampness cannot spread, and the Qi of rainwater also weakens.

When yellow dust rises and yellow winds transform into epidemic Qi, people often suffer pain in their limbs and a bitter taste in the mouth.

Thus, in Chou and Wei years, Shaoyang Qi rises to Heaven and governs. When the Qi of Tianpeng is obstructed, the two overcome one another, delaying the ascent.

After Shaoyin has completed its third year of circulation in the terrestrial arrangement, it rises to Heaven during that year and becomes the Qi of the left interval of Taiyin. This can be determined in advance. But when the Qi of Tianpeng has lost its proper position in the year, the precise timing of its ascent is difficult to calculate. In such a case, Water movement may rise to the position of Fire, so it must not be allowed to ascend rashly.

Also, if Taiyin has not yet moved into its proper position, this means that Shaoyin has not risen to Heaven, while Water movement has already arrived.

(The so-called “should ascend to Heaven but unable to advance” means that it is being held back by these two forms of suppression.)

When the Yangming Qi is blocked from ascending to Heaven, cold Qi spreads everywhere in its place, and the weather turns bitterly cold like winter. The rivers dry up again, and ice forms once more. Warmth appears now and then, but the cold soon returns, leaving temperatures in disorder. People may suffer from Yang Qi trapped within the body and inner-generated heat and agitation; their minds are alarmed and fearful as cold and heat contend. Over time, this gives rise to stagnation.

(The so-called “two sevens without descending” refers to this condition persisting for a long time.)

Then intense heat may suddenly arise, accompanied by red wind—a wind Qi marked by signs of redness—which leaves the eyes dim and clouded, as though covered by a film.

(The illness will break out only when the Qi of the season takes its proper position in the heavens that year.)

Stagnation transforms into pestilential Qi, which then gives rise to hidden heat pathogens lodged within. People become inwardly agitated, their limbs become impeded and numb, and they may suffer reversal. In severe cases, bleeding occurs.

(Red Qi arises and transforms into a great epidemic. Those afflicted are restless and feverish. Cooling medicines can hardly subdue the fire Qi bound up in stagnation. The force of this fire in stagnation exceeds that of sovereign fire, so reversal may occur, followed in severe cases by bleeding.)

Thus, in Yin and Shen years, Yangming Qi ascends to Heaven and governs the obstruction of the Qi of Heavenly Brilliance—the seasonal Qi corresponding to Shaoyin sovereign fire—suppressing it so that it cannot rise.

(Yangming completes its three-year course in the terrestrial realm, then ascends to Heaven in that year and occupies the position of the left sector of Shaoyang. This also establishes the seasonal positions described in the classic. The so-called “nine obstructions” means that, according to the numerical principles of celestial movement, the ascending Qi is insufficient. When Metal Qi encounters obstruction from a Fire phase in the annual movement, it may be suppressed and prevented from ascending to Heaven.)

At times, the year may also be a Wu-Shen or Wu-Yin year, when the Fire phase of the annual movement arrives early.

(When the annual movement is in excess, it begins thirteen days before its appointed period of succession.)

Just as Metal Qi is about to ascend to Heaven, it is suppressed by the Fire phase of the annual movement.

(If either of these circumstances occurs, Metal Qi cannot ascend to Heaven. If both occur at once, the suppression is more severe.)

When Yangming’s ascent to Heaven is blocked, rain does not fall, west winds blow frequently, and the earth produces saline alkalinity and dryness.

(The phrase “saline alkalinity arises” means that the soil takes on a salt-alkaline quality. When substances resembling saltpeter appear, they indicate dryness.)

People may develop heat in the upper body, panting, coughing, and bleeding; over time, the condition develops into stagnation.

(The so-called “four nines without ascending” means that this state of obstruction has persisted for a long time, causing Fire Qi to accumulate in stagnation.)

When white, dust-like mist fills the air, the clear and austere Qi turns into a killing Qi. People may experience fullness and distension in the ribs and flanks, sadness, nasal congestion and a runny nose or sneezing after being exposed to cold, a dry throat, cracked hands, and dry skin.

(When white dust appears, the Qi of killing and conquest arises together with epidemic Qi and fiery Qi. People often suffer from dryness, internal heat, and a dry throat. Acupuncture may be used to treat these symptoms.)

Thus, in the Mao and You years, the Qi of the Sun ascends to Heaven. It originally governs the closing of Qi within Heaven, but is suppressed and cannot continue to rise.

(After circulating on Earth for three years, the Qi of the Sun ascends to Heaven in this year and becomes the left-interstitial Qi of Yangming. This is an established rule of the movement of Qi set out in the treatises on the channels. Once the Qi of the Sun ascends to Heaven, the Qi within Heaven changes accordingly. According to calculations of the movement of Qi, Water Qi is obstructed when it encounters Earth Qi. It cannot overcome Earth Qi and rise, but can only be suppressed until it later has a chance to recover.)

If this also occurs in a year when Yangming Qi has not yet taken its proper position—that is, when the Qi of the Sun has not yet ascended to Heaven, but the Earth phase movement has already arrived—

(This refers to the Ji-You and Ji-Mao years.)

Water Qi tries to ascend to Heaven, but is suppressed by the Earth phase movement.

(Sometimes the Qi within Heaven is obstructed, and Earth Qi restrains Water Qi; sometimes the Earth phase movement itself directly suppresses Water Qi. If either force prevails, Water Qi cannot ascend to Heaven.)

When Water Qi cannot continue to rise, Dampness and Heat steam upward, while Cold arises between Heaven and Earth. People may experience diarrhea, loss of appetite, and difficulty digesting food. If the illness persists, stagnation develops.

(“Twelve days without descending” refers to this state continuing for a long time.)

Cold Qi invades the original Heat Qi, and hail may suddenly fall. People may experience cold, numb hands and feet, vomiting and retching; Heat develops inside the body, while Qi at the body’s surface becomes blocked and fails to flow. The feet and lower legs ache, and people may also suffer palpitations and agitation with internal Heat. Sudden agitation is followed by cold, numb hands and feet.

(From the appearance of black dust until the arrival of the cold epidemic, people may suffer agitation, palpitations, and cold, numb limbs. Treatment may include induced vomiting and similar methods.)

The Yellow Emperor said, “I now fully understand why Water Qi cannot rise, and the resulting palpitations, internal Heat, and sudden agitation followed by cold, numb limbs. I would like to hear more about cases in which descending Qi cannot descend. Could you explain them clearly?”

(The Yellow Emperor wanted to understand the underlying principles further.)

Qibo said, “That is a very thorough question. It concerns the subtle yet important laws governing the movement of Heaven and Earth. Let me explain the principle in full: once Qi rises, it must eventually descend.

After a particular Qi rises to Heaven, in the first year it occupies the left position beside the governing heavenly Qi. In the second year it moves into the central position and governs the climate above. In the third year it withdraws to the right position. In the fourth year it begins to descend.

It circulates in Heaven for three years, and in the following year it must descend. Once it enters Earth, it first occupies the left position. A year later it moves into the central position and governs the climate below; another year later it withdraws to the right position.

This alternating movement of ascent and descent is called the “Six Cycles”: Qi circulates for three years in Heaven and three years in Earth. The two periods together make one cycle. If Qi’s movement in any given year deviates from its proper sequence, it can bring about unusual disasters and illness. We must therefore first understand how Qi rises, then determine how it descends.

In the years of Chou and Wei, Jueyin—the Qi of Wind and Wood—should descend to Earth and govern earthly Qi. But at that time, earthly Qi is blocked and clear Qi cannot pass through. Metal Qi grows strong and obstructs Jueyin, preventing it from moving onward. After circulating in Heaven for three years, Jueyin should descend in the following year. Yet it encounters blocked earthly Qi and is held back by the clear, contracting Qi associated with the West and Metal. It therefore cannot enter Earth. Suppressed and unable to descend, Qi transforms into stagnant Qi, causing illness among the people.

At times, Shaoyin—the Qi of sovereign Fire—has not yet withdrawn from its former position. Its period of circulation in Heaven is not yet complete, and it is still issuing its commands, so it has not left its position.

Jueyin therefore cannot descend. If this also occurs in a Yichou or Yiwei year, when the Metal phase is in command, Metal Qi will suppress Jueyin even further.

Metal Qi follows and suppresses Jueyin, preventing it from descending. The Qi of Wind and Wood is pressed down and becomes congested; unable to descend, it transforms into stagnant Qi and brings on illness.

Wood Qi intends to descend, but Metal Qi obstructs it. In the distance, bluish dust haze appears, followed by white Qi. Wind sweeps up the dust, darkening the sky. A clear, contracting, dry climate sets in, bringing a killing force; frost and dew then fall, and this killing command spreads everywhere. If Qi remains unable to descend for a long time, the suppressed Qi turns into stagnation.

If it has still not descended after three days, it will descend on the eighth day. If it still does not descend, it will transform into an epidemic of wind.”

Wind Qi and scorching heat press against one another. The weather, originally warm, turns cool. Plants begin to sprout, yet frost descends, and hibernating insects have not emerged. Coolness and scorching heat alternate, and the killing Qi fails to appear. Frost and dew fall again, and the command to kill is carried out. If this climate persists for a long time and the killing Qi still cannot descend, it will be suppressed and congeal into stagnant, blocked Qi.

(According to the text, if it has still not descended after three days, it will descend on the eighth day. If it never descends, the stagnant Qi will transform into a wind epidemic.)

Wind Qi and scorching heat press against one another. The weather warms, then turns cool; plants sprout, but frost damages them, and hibernating insects have yet to emerge. This change raises concern that the cool Qi will injure the Jing and Qi stored in the human body.

(The seasonal order should be warm and harmonious, yet suddenly a strong, cool, killing Qi appears. Frost again carries out the command to kill. When gray dust-like Qi appears, a wind epidemic will follow. Treatment should induce vomiting to expel the pathogenic influence; purging should not be used again.)

Thus, in Yin and Shen years, Lesser Yin Qi—one of the Six Qi that governs sovereign Fire—descends from Heaven to Earth and governs the dark, closed condition of Earth Qi. If it is restrained and cannot enter, stagnation will form.

(Lesser Yin Qi governs Heaven for three years and should descend in the fourth. If Earth Qi is closed off at that time, Lesser Yin governs the dark Qi. Water Qi directs the command to descend, preventing Lesser Yin Qi from descending. Suppressed and latent, it then transforms into stagnant Qi and brings illness to the people.)

Sometimes this occurs in a Bing-Shen or Bing-Yin year, when Water’s movement is excessive and arrives ahead of time.

(When Water’s movement is excessive, Lesser Yin Qi reaches the place governed by the central movement but cannot descend. Stagnation forms, bringing calamity and illness to the people.)

Sovereign Fire Qi intends to descend, but Water’s movement restrains it. Though it has begun to descend, it cannot continue downward. Red clouds have just appeared when black Qi begins to grow instead. The weather is warm, as if gently opening and easing, yet cold Qi still spreads; severe cold returns, and the sky grows dark and bleak. If the Qi cannot descend for a long time, the suppressed Qi will turn into stagnation.

(According to the text, if it has not descended after two days, it will descend on the seventh day. If it still does not descend, it will build up and break out.)

After cold Qi gains the upper hand, it turns to heat, and red wind transforms into an epidemic. People develop flushed faces, agitation in the heart, headaches, and blurred vision. When red Qi is conspicuous, warm disease is about to arise.

(The people will all sleep restlessly at night. Yellow wind will transform into an epidemic. Once the illness has eased, it can be treated with purging.)

Thus, in Mao and You years, Greater Yin Qi—one of the Six Qi that governs damp Earth—descends from Heaven to Earth and governs Earth Qi’s closed, dim, and indistinct condition. If it is restrained and cannot enter, stagnation will form.

Taiyin, the Yin-type Qi in the Earthly Branches and climate-cycle theories, circulates in Heaven for three years. In the following year it descends into Earth and becomes the left interstitial Qi of Shaoyin. If, however, the governing Qi is obstructed and Earth Qi is abundant and flourishing, with Wood Qi holding the advantage, Taiyin cannot descend into Earth.

If Shaoyang has not yet withdrawn from its position, Taiyin cannot descend. This may also be due to the arrival of a Wood phase year.

(Dingyou and Dingmao years belong to the Wood phase.)

Wood phase Qi receives and carries this influence. Although Taiyin is due to descend, it cannot enter Earth. Yellow clouds then appear, and blue-green clouds become prominent. The weather turns oppressive and steaming hot, while strong winds, dense fog, and dust prevail, followed by damage and decline. If Taiyin remains unable to descend for a long time, its Qi lies hidden and produces changes through stagnation.

(Ten days without descent counts as a long time.)

Yellow dust clouds fill the sky, while dampness rises from the ground. People may suffer from weakness in the limbs, mental cloudiness and dizziness, joint pain, abdominal distension, and fullness or oppression in the chest.

(When yellow winds rise three times, people are prone to warm-damp illnesses, often with focal distension and fullness. Strong purgation can be used to treat them, and the illness will then resolve.)

Thus, in Chen and Xu years, Shaoyang Qi descends into Earth and becomes the left interstitial Qi of Taiyin. If the governing Qi is obstructed and Earth Qi is abundant and dark, with Water Qi holding the advantage, Shaoyang cannot enter Earth.

(After circulating in Heaven for three years, Shaoyang descends into Earth the following year and becomes the left interstitial Qi of Taiyin. If the governing Qi is obstructed and Water Qi prevails, Shaoyang cannot enter, bringing corresponding climatic changes and illnesses among the people.)

If this also coincides with an excessive Water phase year, Water Qi arrives earlier than its normal season.

(Bingchen and Bingxu years belong to the Water phase.)

Water phase Qi receives and carries this influence. Shaoyang descends but cannot enter Earth. Red clouds have only just appeared when black Qi emerges instead. The weather is about to turn warm, yet cold suddenly arrives; in severe cases, hail falls. If Shaoyang remains unable to descend for a long time, its Qi lies hidden and becomes congested.

(If it has not descended after two days, it will descend after seven days. If it still does not descend, the congested Qi will erupt.)

After the cold passes, heat returns, and red winds bring epidemics. People may develop a flushed complexion, inner agitation, headache, and blurred vision. When red Qi becomes prominent, heat illnesses are about to arise.

(People may be unable to sleep peacefully at night. When yellow winds bring epidemics, treatment can be given by promoting discharge.)

Thus, in Si and Hai years, Yangming Qi descends into Earth. If the governing Qi is obstructed and Earth Qi takes on a vivid red hue, Yangming is suppressed and cannot enter.

When Yangming Qi has moved through the heavens for three years, in the fourth year it should descend into the earth and become the left-side Qi of Shaoyang. If the Earth Qi is blocked at that time, and Fire Qi takes charge and suppresses it, preventing it from entering the earth, illness may result. It may also be that Taiyin Qi has not yet withdrawn, so Shaoyang Qi cannot descend into the earth.

When Yangming Qi has moved through the heavens for three years, in the fourth year it should descend into the earth and become the left-side Qi of Shaoyang. If the Earth Qi is blocked at that time, and Fire Qi takes charge and suppresses it, preventing it from entering the earth, illness may result. Taiyin may also not yet have withdrawn, preventing Shaoyang from descending; Fire then arrives in its place. This occurs in the Gui-si and Gui-hai years.

When Fire takes over but cannot descend, the sky is clear and crisp, and reddish Qi appears, yet warmth arises instead. People become drowsy and weary, sleep restlessly at night, feel dryness in the throat and thirst, and experience inner agitation and heat. The clear, crisp Qi intensifies in the morning and evening, while warmth repeatedly returns. Fire Qi remains hidden, unable to descend for a long time, and then becomes constrained and changes. The phrase “nine days without descending” is explained in the commentary as follows: after four days without descending, it descends on the ninth day; if it still does not descend, the constrained Qi breaks out.

When the weather is clear and cold, with a slight chill, and white Qi appears in the distance, people may suffer dizziness and unsteadiness, stiffness and numbness in the hands and feet, discomfort in both sides of the torso, and blurred vision. The commentary adds that when white Qi becomes excessive and the killing Qi arrives, people are prone to dryness and heat, dryness in the throat, and nasal congestion or nosebleeds. Acupuncture may be used to treat these conditions.

Thus, in Zi and Wu years, when Taiyang Qi descends into the earth, if the Earth Qi is blocked and Earth Qi takes charge and suppresses it, it may descend but still fail to enter beneath the earth.

When Taiyang Qi has moved through the heavens for three years, in the fourth year it should descend into the earth again and become the left-side Qi of Yangming. If the Earth Qi is congested, and Earth Qi takes charge and suppresses it, it cannot enter the earth. It may also encounter an excessive Earth phase movement, with Earth Qi arriving ahead of time. This occurs in the Jia-zi and Jia-wu years.

The Earth phase carries forward the qi of the Celestial Controller. If the qi descends but cannot enter the earth, dense black qi appears in the sky, the heavens grow dim, and the scene becomes desolate. Only then do yellow dust clouds begin to rise and dampness spread, as cold qi and dampness steam and mingle. If the qi cannot descend for a long time, it lies hidden and accumulates without dispersing.

(If the qi has still not descended after twelve days, the accumulated qi will break out.)

The people may suffer severe reversal syndromes—disordered qi and blood, cold hands and feet, and similar symptoms—along with heaviness and fatigue in the limbs, weakness of the genital region, and lack of strength. The sky is filled with gloomy qi, and dampness steams up from time to time.

(When black qi appears, a cold epidemic is approaching, and the people will fall ill. If the qi has not descended after two days, the accumulated qi will break out.)

The people may suffer severe reversal syndromes, heaviness and fatigue in the limbs, weakness of the genital region, and lack of strength. The sky is filled with gloomy qi, and dampness steams up from time to time.

(When black qi appears, a cold epidemic is approaching, and the people will fall ill. Many will show symptoms of reversal and bodily heaviness; treatment may appropriately include tonification.)

The Yellow Emperor asked, “When the qi’s ascent and descent do not proceed on schedule, how can we understand the underlying cause? I would like to know what is meant by ‘taking up the correct position.’ Can you explain it clearly?”

(“Clear” means to understand.)

Qibo replied, “When the qi of the Celestial Controller moves into the central position it is meant to occupy, this is called ‘taking up the correct position.’ If the Celestial Controller’s qi does not take up its position on schedule, it means the previous Celestial Controller has remained in office beyond the time for handover.”

(This is because the qi of the new year is not established until after the day of Major Cold, and the first qi period has not yet arrived.)

It may also be that the Celestial Controller’s period of influence has run long, so it continues to govern according to the old seasonal order, and the new Celestial Controller has not yet taken up the correct position.

(Although the year may already have changed, the Celestial Controller’s qi may not yet have been handed over.)

When the qi of Jueyin cannot take up the correct position, wind and warmth arrive out of season, and flowers and grasses wither. The people may experience dribbling urination, pulling discomfort around the eyes, cramping tendons, emotional volatility, and reddish urine.

(If Taiyang is the Celestial Controller and remains in office past its proper term because the seasonal cycle has run long, then when it finally withdraws, Jueyin can take up the correct position.)

Wind qi should be governing, but cold qi is slow to withdraw. The weather is unseasonably warm and mild, disrupting the normal order of spring.

(Even if the first qi period has arrived, if the Celestial Controller’s decree has not yet spread, Wood qi cannot unfold, and the people will suffer liver disorders.)

When the qi of Shaoyin cannot take up the correct position, cold qi cannot withdraw on schedule.

The Qi of wind and Wood, which should stir into growth in spring, remains held back by cold. The weather is not warm enough, and spring loses its proper season.

(Even after the first Qi has begun, the seasonal mandate has not yet been transmitted. Wood Qi cannot unfold, and people may develop liver illnesses.)

When lesser Yin, the Qi of sovereign Fire, fails to take its proper position at the appointed time, the cold does not recede, and spring remains chilly. Warm weather arrives out of season, and people may suffer illnesses in which chills and fever alternate, along with aching and discomfort in the limbs and stiffness in the lower back and spine.

(Although the wind and Wood Qi governing the heavens under reverting Yin has a surplus of days, the other Qi positions that take turns governing the heavens must wait until the incumbent’s allotted days have ended before they can take their proper positions. For example, when lesser Yin reaches the spring equinox in the second month, the time when it should assume its position, the transformation of Qi between Heaven and Earth changes, allowing it to take that position. This is what accords with the proper time for governing the heavens.)

Though Wood Qi still has some force in reserve, its period in office cannot extend beyond that of sovereign Fire.

(Though Wood Qi has surplus days, it cannot use up all those extra days before governing the seasonal Qi. If its period of governance has not ended when sovereign Fire is due to transform in its appointed season, it may take its proper position at the spring equinox. Wood Qi may not yet have withdrawn, so it can govern the seasonal Qi together with sovereign Fire. The other surplus Qi do not work this way.)

When greater Yin, the Qi of Earth, fails to take its proper position at the appointed time, clouds and rain lose their seasonal order. All things wither and scorch, and those that should grow cannot sprout. People may suffer swelling in the joints of the hands and feet, abdominal edema, tightness in the chest that prevents eating, diarrhea with undigested food, distension and fullness along the ribs, and inability to move the limbs.

(The allotted days for lesser Yin to govern the heavens have not yet ended, so greater Yin cannot take its proper position. Only after lesser Yin’s term has ended can greater Yin assume it.)

The transformation of rain, which should be brought about by greater Yin, ought to take effect, but heat remains in command. Warmth grows excessive and dries things out, leaving it unable to moisten the myriad things.

(Lesser Yin still has Qi in reserve, and its allotted days have not ended. Greater Yin can take its proper position only once lesser Yin’s term is over.)

The transformation of rain ought to take effect, but heat remains in command. Warmth grows excessive and dries things out, leaving it unable to moisten the myriad things.

(Lesser Yin still has Qi in reserve, and its allotted days are not yet over, so it does not withdraw. Greater Yin therefore cannot take its proper position, and Earth Qi cannot unfold. People may consequently develop spleen illnesses.)

When lesser Yang, the Qi of ministerial Fire, fails to take its proper position at the appointed time, heat cannot recede when it should, and neither crops nor weeds can grow luxuriantly. Autumn remains fiercely hot; the killing force of autumn arrives late, and frost and dew do not appear on schedule. People may suffer intermittent malaria, heat in the bones, palpitations and fright, and, in severe cases, bleeding.

(Even in Yin or Shen years, Earth Qi remains in command…)