《黃帝內經素問補註釋文》Vol. 31

The Yellow Emperor asked, “I would like to understand the essentials of deficiency and excess.”

Qi Bo replied, “When Qi is abundant and the body is robust, or when Qi is deficient and the body is weak, this is normal. The opposite is pathological.

The Treatise on the Correspondences of Yin and Yang says that the body depends on Qi to exist. Therefore, deficiency or excess in Qi and in the body should ordinarily correspond. By ‘the opposite’ we mean that the two do not correspond and have departed from the normal state. Qi refers to the Qi in the vessels, and form refers to the body’s outward appearance. When Qi and the body do not correspond, illness results.

“When the intake of grain is sufficient, Qi is also sufficient; when grain is insufficient, Qi is also insufficient. This is normal. The reverse is pathological.

The Spiritual Pivot says that the movement of nutritive Qi depends on food. When food is plentiful, after grain enters the stomach, its refined essence is conveyed to the lungs, which then distribute it through the vessels. The Qi produced from grain in the diet should therefore correspond to the abundance or deficiency of Qi. When they do not correspond, illness results.

“When Qi and blood in the vessels are abundant, blood is also abundant; when Qi and blood in the vessels are deficient, blood is also deficient. This is normal. When deficiency or excess in the vessels does not correspond to the state of the blood, illness results. The vessels are the channels through which blood circulates, so their abundance or deficiency should ordinarily match that of the blood.”

The Yellow Emperor asked, “What counts as the opposite?”

Qi Bo replied, “When Qi is deficient but the body is feverish, that is called the opposite. Deficient Qi means that Yang Qi is insufficient, which should normally cause a person to feel cold. If there is fever instead, it means that the vessel Qi ought to be vigorous but is not, and so it does not correspond to the signs shown by the body. That is why it is called the opposite.

“When a person eats a great deal but has little Qi, that too is called the opposite. The stomach sends out the grain Qi produced from food. After grain enters the stomach, its Qi should spread through the vessels. If a person eats a great deal but has little Qi, the stomach Qi has not been distributed normally; hence this is called the opposite.

“When a person has not eaten but has abundant Qi, that too is called the opposite. This is because stomach Qi disperses outward, and the lungs then gather and concentrate it.

“When vessel Qi is vigorous but blood is scant, that is the opposite; when vessel Qi is deficient but blood is abundant, that too is the opposite. The channels carry Qi, while the network vessels receive blood. Qi from the channels enters the network vessels, which also receive Qi from the channels. Whenever the signs of Qi and blood are out of balance, the condition is abnormal.”

When Qi (vital energy) is abundant but the body feels cold, this is due to an invasion of Cold pathogen. When Qi is weak but the body feels hot, this is due to an invasion of Summer-heat pathogen.

“Damage” means to encounter or be affected by something. Cold pathogen harms the body’s physical form, so Qi is abundant while the body feels cold. Heat pathogen harms Qi, so Qi is deficient while the body feels hot.

When a person eats a lot of grain but has little Qi, this is caused either by blood loss or by Dampness lingering in the lower part of the body. Blood loss causes blood deficiency. When blood is deficient, Qi becomes abundant and stagnates within the body, transforming into body fluids that flow into the Lower Burner, the lower part of the body. This is why it is said that Dampness lingers below.

When a person eats little grain but has much Qi, pathogenic Qi is present in the stomach and lungs. When stomach Qi is insufficient, lung Qi flows downward into the stomach, which is why pathogenic Qi is said to be in the stomach. When lung Qi enters the stomach, it can no longer remain in its proper place. Once lung Qi cannot hold its position, pathogenic Qi follows it; this is why pathogenic Qi is said to be in both the stomach and lungs.

A fine, small pulse with a relatively large volume of blood indicates heat within retained fluid, water that has accumulated and failed to disperse. When this fluid remains in the spleen and stomach, it causes spleen Qi to become congested and overflow, which then produces heat.

A large pulse with a relatively small volume of blood occurs when Wind Qi is present in the vessels and fluids cannot enter them. When Wind Qi is abundant and fills the vessels, fluids cannot enter.

Excess means Qi is entering; deficiency means Qi is leaving. When Qi moves from within to the outside, it forms Yin. Yang Qi arises on the outside, so when Qi enters the body, it forms Yang.

When Qi is excessive, it causes heat; when Qi is deficient, it causes cold. When Yang Qi is abundant, Yin Qi resists it from within, and heat results. When Yin Qi is abundant and Yang Qi is weak on the outside, cold results.

When needling an excess condition, the left hand should open the needle hole. When needling a deficiency condition, the left hand should close the needle hole. This describes how to tonify and drain during needling: the right hand holds the needle, while the left hand presses and rolls over the acupoint. For an excess condition, the right hand opens the needle hole to drain; for a deficiency condition, the left hand opens it to tonify. The word “nian” is pronounced “nie.”

“Explaining the Needles”

The Yellow Emperor asked, “I would like to hear an explanation of the Nine Needles, the ancient acupuncture tools, and the principles of deficiency and excess.”

Qibo replied, “Needling a deficiency condition to make it full is shown by warmth beneath the needle: when Qi becomes full, it produces heat. When Qi is full, it should be drained, which is shown by coolness beneath the needle: when Qi becomes deficient, it produces cold. Long-standing, stagnant pathogenic blood should be cleared away; that is, needling should release the bad blood.”

“Stagnant” means accumulated, and “long-standing” means present for a long time. In other words, blood that has accumulated over time in the collaterals, the finer vessels, should be cleared by needling.

“When pathogenic Qi is abundant, use the draining method to reduce it, and do not press the needle hole after removing the needle.”

Here, “pathogenic” means disordered Qi, that is, Qi that does not belong to the proper Qi of the relevant channel. The original text ends here unfinished.

Diseases caused by pathogenic influences such as ghosts and malign forces are among the conditions acupuncture seeks to dispel. After inserting and then withdrawing the needle, do not press the puncture site. Leave the point open briefly so that pathogenic Qi in the channels can disperse.

The “slow then fast” technique can replenish the weak: withdraw the needle slowly, then quickly press the puncture site. The “fast then slow” technique can drain excess: withdraw the needle quickly, then press the puncture site slowly.

“Slow withdrawal” means leaving the needle in the point for a time and withdrawing it once channel Qi has arrived. “Quick pressing” means covering the puncture site immediately after removing the needle. This prevents genuine Qi from escaping and preserves Qi in the channels. This is therefore called “slow then fast,” and is used to replenish deficiency.

“Quick withdrawal” means removing the needle as soon as it reaches the channel after insertion. “Slow pressing” means gradually pressing the puncture site after withdrawal, allowing pathogenic Qi to escape while enabling essence Qi to return to its secure position. This is therefore called “fast then slow,” and is used to drain excess.

Here, “excess” and “deficiency” refer to the relative abundance of cold and heat Qi. “Cold and heat” describe the state of Yin-Yang Qi in the channels.

“Like something, yet nothing” means that the condition is subtle and hard to discern, and cannot be recognized at once. Since it cannot be seen clearly right away, it seems as if nothing is there; with keen observation and sudden insight, it then seems as if something has been detected.

“To examine what came before and after” means to determine the order in which the condition arose. Only by clarifying this sequence can one decide whether to replenish or drain.

When diagnosing deficiency and excess, the practitioner must not violate the corresponding methods. The Needle Classic says, “When channel Qi has arrived, attend to it carefully; do not miss the moment.” This is what it means.

The New Corrected Edition says: The A-B Classic reads “as though present, as though absent,” describing deficiency and excess.

“Like gaining, like losing” refers to departing from the correct needling method. Replenishing and draining at will violates and disrupts the fundamental principles: treating an excess condition as deficiency and replenishing it makes the illness more excessive; treating a deficiency condition as excess and draining it makes the illness more deficient. Hence the phrase “like gaining, like losing.” The Needle Classic says, “Do not replenish excess as though it were deficiency, and do not drain deficiency as though it were excess.” This is a warning to the practitioner.

The New Corrected Edition also says: From the beginning of the chapter up to this point, the text matches the classic passage in the Taishu, “Explanation of the Nine Needles,” though the explanations differ. The two books can be consulted together to supplement one another.

The key to regulating deficiency and excess lies in the distinct uses of the nine needles:

• When heat pathogens lodge in the head or at the body’s surface, the chan needle is suitable.
• When Qi is abundant and congested between the muscle fibers, the yuan needle is suitable.
• When channel Qi is deficient, the di needle is suitable.
• To drain heat, prick for blood, or release pathogens, the feng needle is suitable.
• To open abscesses and release pus and blood, the pi needle is suitable.
• To harmonize Yin-Yang and treat sudden attacks of Bi syndrome, the yuanli needle is suitable.
• For pain or numbness in the channels and collaterals, the hao needle is suitable.
• When Bi syndrome reaches deep into the spaces between bones, the lumbar spine, joints, or muscle fibers, the long needle is suitable.
• For deficiency conditions in which wind pathogens lodge in the bones, the large needle is suitable.

For conditions affecting the skin and flesh, it is appropriate to use the large needle. In other words, each type of needle is suited to its own particular conditions.

The New Collation says: A comparison of other editions shows that “Fei” is written as “Pi” in some versions (“Di” is read as “di”).

The timing of tonifying and reducing must accord with the opening and closing of the channel Qi.

When the channel Qi is moving at its corresponding time, this is called “open”; when that time has passed or has not yet arrived, it is called “closed.” For example, when the water clock marks the first quarter, the body’s Qi moves through the Taiyang channel; at the second quarter, through the Shaoyang channel; at the third, through the Yangming channel; and at the fourth, through the Yin aspect. As the hours advance, the channel Qi continues to flow. When the Qi reaches the time corresponding to a particular channel, this is called “open”; when that time has passed or has not yet arrived, it is called “closed.” The Needle Classic says, “Carefully observe where the channel Qi is, then insert the needle.” This is called “meeting the time,” and refers to the timing of tonifying and reducing described here.

The New Collation says: The passage from the beginning of the chapter to this point comes from the Spirit Pivot. The Plain Questions and the Spirit Pivot can be used to clarify one another. After “the timing of tonifying and reducing,” the Jia Yi Jing includes the four words “when carrying this out with a needle,” which are omitted here.

The nine needles have different names and shapes so that the appropriate needle can be chosen for each condition and used to tonify or reduce. Their different shapes refer to variations in length and tip; their distinct uses mean that different needles are selected according to the needs of treatment.

The New Collation says: The shapes of the nine needles, as recorded in the Nine Needles, are now included in the Jia Yi Jing.

When needling an excess condition, the aim is to make the pathogenic Qi recede: retain the needle, then withdraw it once Yin Qi has become abundant. When needling a deficiency condition, the aim is to strengthen the healthy Qi: withdraw the needle once Yang Qi is abundant and heat is felt beneath it. This means that needling takes effect only when the channel Qi has arrived.

Once the channel Qi has arrived, guard it carefully and do not miss its moment. “Change” means to alter; “replace” means to switch. Both refer to changing the needling method. The point is that after Qi has arrived, one must carefully maintain the method and not alter it arbitrarily, or harm may result.

The depth of needling depends on the practitioner’s assessment of the condition—that is, on distinguishing whether the illness is located internally or externally. “Intention” can also mean focused attention; intention and concentration are both needed when needling.

Whether the affected site is near or far, the criterion for determining whether the channel Qi has arrived is the same. In other words, although the Qi travels varying distances, its arrival is the basis for judging whether treatment is taking effect.

During treatment, be as cautious as if standing at the edge of a deep abyss, and never become careless. When observing the channel Qi and applying tonification or reduction, take the same care as when approaching an abyss, so as not to neglect or violate the method.

Apply the technique with the strength of someone gripping a fierce tiger.

When holding the needle, keep a firm, steady grip. The Needle Classic says that the way to hold a needle is to do so firmly. Here, “firmly” means using steady force and technique during needling.

Do not let things around you distract your mind and spirit. Quiet your mind and observe the patient; do not look this way and that. Keep your gaze from wandering and your attention focused on needling. This makes it easier to work accurately and avoid confusion or mistakes. The Newly Corrected Commentary says that the passage beginning “When needling excess, one must wait for deficiency” and ending here also appears in the “Treatise on Preserving Life in Full” (Baoming Quanxing Lun); the two passages can be read together to clarify and supplement one another.

When inserting the needle, do not angle it. Insert it straight and upright, without leaning to either side.

“Be sure to set the spirit aright” means to watch the patient’s expression while needling and help the patient’s spirit settle, allowing Qi and blood to flow smoothly. Observe and gather the patient’s spirit so that it does not become scattered; this makes it easier for the Qi activity inside and outside the body to come into harmony.

“Sān lǐ” is the name of an acupuncture point three cun below the knee. “Foot dorsum” refers to the top of the foot. Raise the knee, and the boundaries along the leg become easier to see.

Sānlǐ is the name of a point located three cun below the knee, between two muscular bands on the outer side of the shinbone. Pressing firmly there stops the arterial pulse on the top of the foot. Thus, after raising the knee, the boundaries along the leg are easier to distinguish.

“Jùxū” is the name of an acupuncture point. When the foot is lifted to locate it, a hollow appears between two muscular bands on the outer side of the shinbone. “Qiāo” means to lift or raise. To locate Jùxū Xiàlián, raise the foot and look for the hollow between the two muscular bands on the outer side of the shinbone.

“Xiàlián” refers to a sunken place. To find the Xiàlián point, look for the hollow that lies by itself between the two muscular bands on the outer side of the shinbone.

The Yellow Emperor said, “I have heard that the nine needles correspond to Heaven and Earth, the four seasons, and Yin-Yang. I hope to hear how this works, so that it may be passed down to later generations as a constant rule.” Qí Bó replied, “The first is Heaven, the second Earth, the third humanity, the fourth the four seasons, the fifth the five tones, the sixth the six pitch standards, the seventh the seven stars, the eighth the eight winds, and the ninth the nine regions. The human body corresponds to them as well. Each needle has its proper use; this is why they are called the ‘nine needles.’” The Newly Corrected Commentary notes that this passage is connected with the corresponding material in the Ling Shu Jing.

A person’s skin corresponds to Heaven. Heaven covers all things, and the skin covers the body.

A person’s flesh corresponds to Earth. Flesh is soft, substantial, and stable, and thus symbolizes Earth.

A person’s channels correspond to humanity, and a person’s tendons correspond to the four seasons.

A person’s pulse changes with the waxing and waning of Qi and blood, and thus corresponds to the image of “humanity.” The tendons are firm and have a fixed character, corresponding to the image of “time,” as the four seasons follow their regular cycle. The human voice has the distinctions of gong, shang, jue, zhi, and yu, comprising the Five Tones, and thus corresponds to “tone.” Yin-Yang Qi in the body meets and circulates, giving rise to one another without end or interruption; this corresponds to “pitch,” referring to the twelve pitch pipes used in antiquity to set musical pitches and mark the seasonal Qi. The teeth and face correspond to the “stars”: the face has seven orifices, which correspond to the seven stars, according to Quan Yuanqi’s commentary. The Qi of breathing in and out flows back and forth, corresponding to “wind.” The body’s nine orifices and 365 channels are distributed across its outer form like the open countryside, and thus correspond to the “wilds.”

Each of the nine needles therefore has its own function: the first treats the skin, the second the flesh, the third the vessels, the fourth the tendons, and the fifth the bones. The sixth harmonizes Yin and Yang; the seventh supplements Jing and Qi; the eighth dispels pathogenic wind; and the ninth opens the nine orifices and expels pathogenic Qi from the 365 joints. This is what is meant by each having its own function. In order, the nine needles are the can needle, the round needle, the spoon needle, the lance needle, the sword-shaped needle (also called the pi needle), the round-sharp needle, the fine needle, the long needle, and the large needle.

A person’s mental activity, whose movement and stillness have no visible form, corresponds to the “eight winds.” A person’s upright Qi circulates without ceasing and corresponds to “Heaven.” The growth of hair and teeth, the clarity and acuity of hearing and sight, and the correspondence between the five vocal sounds and the Five Tones also accord with the six pitch standards. The body’s Yin-Yang vessels and Qi and blood meet and transform, and undergo fullness and depletion, waxing and waning; they therefore correspond to “Earth.” The liver opens into the eyes and belongs to Wood. Three is the generating number of Wood, and three times three equals nine, so the liver also corresponds to “nine.”

The text goes on to say that observing the heavens reveals a person’s movement and stillness. The five colors are used to assess the complexion, while the seven stars provide a correspondence for observing whether the hair is lustrous. The Five Tones distinguish gong, shang, jue, zhi, and yu, and correspond to the excess or deficiency of the six pitch standards. The rises and depressions of the land correspond to the nine regions; the joints and acupoints are used to diagnose whether the movement of Qi is obstructed. Changes in the body are also assessed through the condition of the teeth, to determine whether Qi is leaking.

“Changes in the abundance of blood by a fraction of ten; five fractions to assess whether it is slow or urgent; six fractions falling short of three, with cold affecting the joints; the ninth fraction concerns the cold, warmth, dryness, and dampness of the four seasons. In each season, one response is used to assess what runs counter to it; in each of the four directions, a separate explanation is given.”

This passage contains 124 characters. The bamboo slips are damaged, and both the wording and the meaning are incomplete, so the text cannot be verified. Since it comes from an ancient classic, it is recorded here as it stands, for later scholars to complete. The Corrected Text notes: Wang Bing’s annotated edition says this passage contains 124 characters, whereas the version seen today has only 123; one character has been lost.

Treatise on Deep Needling

A physician practicing acupuncture need not take the pulse, but can simply listen to the patient’s account: if the illness is in the head and the patient has a headache, insert the needle more deeply. “Cang” means deep, so this refers to deep needling. The text below also says, “needle until the bone is reached.” The Corrected Text notes: according to the Quan Yuanqi edition, this passage reads “for needling,” without the character “cang.”

When the needle reaches the bone, stop once the illness is cured; do not injure the bone, flesh, or skin. “Skin” refers to the tissues the needle passes through, so even when needling to the bone, the bone, flesh, and skin must not be injured.

If the head is affected by cold or heat, treat it with Yin needling. This means inserting one needle at a point, then needling four points around it. The Corrected Text notes: some editions write “sudden needling” as “level needling.” According to the Jing of Acupuncture and Moxibustion, Yang needling means inserting one needle in the center and four more around it, while Yin needling means quickly inserting needles on the left and right. Therefore, “Yin needling” here may need to be read as “Yang needling.”

When pathogenic factors have penetrated deeply and are confined within the body, needle the five organs.

When pathogenic factors press close to the organs, needle the Back-Shu points. These are points on the back through which the Qi of the five organs connects with the body’s surface. “Press close” means to approach: as pathogenic factors gradually draw near the organs, needle the Back-Shu points of the five organs.

Why needle these points near the organs? Because they are where the Qi of the organs gathers. There is no need to follow a fixed number of needle insertions when needling the Back-Shu points; continue until the signs of cold or heat in the abdomen have subsided.

When needling the various Shu points, use the method described above. The key is to withdraw the needle shallowly, allowing only a little blood to emerge.

To treat a necrotic swelling, needle the affected area, adjusting the depth according to the swelling’s size and depth. “Necrotic swelling” refers to a lump whose inner flesh has decayed and turned into pus and blood. Needle shallowly for a small swelling and deeply for a large one. The Corrected Text notes: according to the Quan Yuanqi edition and the Jing of Acupuncture and Moxibustion, “necrotic” here should read “abscess.”

If the abscess is large, release more blood; if it is small, simply insert the needle directly.

The Newly Revised Text says: According to the Jia Yi Jing, this passage should read, “For a large one, puncture more often and more deeply; the needle must be inserted straight, according to a set method.” The wording here, “for a small one, needle deeply,” is probably an error.

When disease is in the lower abdomen and there is a mass, needle downward from the end of the transverse bone below the navel (Pi Kuo), stopping when you reach the lower abdomen. Then needle beside the spine, between the fourth vertebra, at the Liao points on both sides of the iliac region (points at the sides of the lower back), and between the lower ribs. This can guide the Qi in the abdomen and disperse the heat downward.

A mass in the lower abdomen refers to cold and heat Qi gathering there. Pi Kuo is located about five body-inches below the navel; a “body-inch” is a measurement for locating points based on the patient’s own proportions. After locating the point, insert the needle carefully and do not go too deep. The Treatise on Needling Prohibitions says that if needling the lower abdomen strikes the bladder, urine will leak out and the lower abdomen will become distended. This is why the text warns against needling too deeply.

The classic gives no corresponding acupuncture point for “beside the spine, between the fourth vertebra.” It is likely meant to say “between the fifth vertebra”: the points on either side below the fifth vertebra are the Heart Shu points. The Heart corresponds to the lower abdomen, which is why this location is mentioned. “Iliac” refers to the hip bone; “Liao” is a point on the side of the lower back, namely Juluo. “Iliac” may also be a copying error for “thigh bone,” since the characters resemble one another. “Between the lower ribs” should refer to the Jingmen point between the lowest ribs.

The Newly Revised Text also says: The Shiyin writes “Pi Kuo” as “Pi Guo”; the character “Guo” in the original should be “Kuo,” a scribal error. A search through rhyme dictionaries finds no character “Guo” in this form, only “Kuo,” meaning the end of a bone. “Pi Kuo” probably refers to the end of the transverse bone below the navel. The edition by Quan Yuanqi reads “Pi Sui,” which Quan Yuanqi explains as the raised area beside the navel, but that explanation is also inaccurate. “Iliac” is pronounced with the fanqie spelling “Kou Ya,” and “Kuo” with “Guang Mo.”

When disease is in the lower abdomen, with abdominal pain and difficulty passing urine or stool, it is called shan, a disorder caused by exposure to cold. Needle the lower abdomen, the area between the thighs, and the spaces between the hip bones. Needle repeatedly until the area feels warm, and the disorder will resolve.

The channels of Jueyin encircle the genitals and ascend to the lower abdomen. The Chong Mai and the collateral vessels of the Shaoyin channel also begin below the kidneys, emerge at Qijie, and run along the front of the inner thighs. Another branch of the Shaoyin channel runs backward from the lower abdomen to the center of the pelvis; in women, this channel enters and connects with the Ting opening, the aperture of the genitals. Its collateral vessel runs along the genitals and joins at the perineum. After circling the perineum, it branches around the buttocks until it reaches the place where the collateral vessels of the Shaoyin and Foot Taiyang channels meet, then ascends along the back edge of the inner thigh and passes through the spine…

The disease is located in the kidneys. In men, the pathogenic influence travels downward along the penis and reaches the perineum; the same is true for women. Therefore, needle the lower abdomen and the area between the thighs, as well as the spaces between the hip bones in the lower back.

The spaces between the hip bones are the hollows on either side of the lower back, near the spine, where bone can be felt beneath the fingers. Hernia is caused by cold, so needle the lower abdomen in several places until the whole area feels warm. Here, “jiong” means heat. The New Collation notes: Other editions write “cuan” as “ji”; the two characters had similar pronunciations in ancient times.

When disease affects the sinews, they contract and the joints hurt, making it impossible to walk. This is called sinew impediment. Needle where the sinews are, with the aim of freeing their flow. Insert the needle at the boundaries between the muscles, taking care not to strike bone. “Boundaries” here refers to places where the sinews and connecting channels meet at the divisions between muscles. Since needling the sinews must not injure the bones, the needle should not strike bone.

When the sinews in the affected area become warm, stop needling once the disease has cleared. Obstructed sinews give rise to impediment, so the aim is to warm them; when the disease is gone, needling can stop.

When disease affects the flesh and causes pain throughout the body, this is called flesh impediment. It results from injury by cold and dampness. Needle the boundaries between both large and small muscle groups, using many needles and inserting them deeply, with the aim of warming the affected area. “Large divisions” means the boundaries between large muscle groups; “small divisions” means the boundaries between small muscle groups.

While needling, do not injure the sinews or bones, or this may cause an abscess or alter the course of the disease. The Needle Classic says, “If the disease is superficial but the needle is inserted too deeply, healthy flesh and skin will be injured, producing an abscess.” It also says, “If the needle is inserted too deeply, the pathogenic influence may instead sink into the body, worsening the disease.” Injury to the sinews or bones means the needle has gone too deep, and may therefore cause an abscess or change the disease.

When all the muscle divisions have become warm, stop needling once the disease has cleared. Heat disperses cold, so needling should stop when the disease is gone.

When disease affects the bones, they feel heavy and are difficult to lift; the marrow aches, and cold has entered the body. This is called bone impediment. Because the disease lies deep, avoid injuring the vessels and flesh when needling. The aim is to make Qi flow through the divisions between large and small muscle groups. When the bones become warm and the disease has cleared, stop needling. Why avoid injuring the vessels and flesh when needling bone impediment? Because the needle is directed at the place where Qi moves and passes through the divisions between the muscles.

When disease affects the Yang channels, the Qi in them alternates between cold and heat, and the muscle divisions throughout the body likewise turn alternately cold and hot. This is called “madness,” referring here to disordered Qi. When needling, reduce the Qi in the channels and examine the muscle divisions throughout the body. Once these areas have all become warm and the disease has cleared, stop needling.

When an illness first begins, if it occurs once a year, it is difficult to treat; if it occurs once a month, it is also difficult to treat. When it occurs four or five times a month, it is called dianbing. Needle the muscle divisions and channels throughout the body. If there are no signs of cold in the channels, use the needle to regulate them, stopping when the disease has cleared. The New Collation notes: According to the Jia Yi Jing, the original text reads, “Needle the muscle divisions throughout the body; where the channels are especially cold, use the needle to tonify.”

When wind disease strikes, the patient alternates between feeling cold and hot, the body becomes hot and sweats, and attacks occur several times a day. First needle the muscle divisions throughout the body.

Unblock the network vessels, induce sweating, and relieve the symptoms of alternating chills and fever. Acupuncture once every three days for one hundred days, and the condition will improve.

In severe dafeng (literally “great wind,” an ancient term for a group of skin and systemic symptoms), the joints may feel heavy and the beard and eyebrows may fall out. This is called “great wind.” Acupuncture the muscles to induce sweating for one hundred consecutive days, dispersing the heat pathogen lodged in the defensive Qi.

Then acupuncture the bone marrow to induce sweating for another one hundred days, dispersing the heat pathogen lodged in the nutritive Qi that circulates in the vessels. After two hundred days in all, stop acupuncture once the beard and eyebrows have grown back.

As the heat pathogen recedes and Yin Qi is restored, sweating increases, and the beard and eyebrows grow back.