《黃帝內經素問補註釋文》Vol. 32

The Yellow Emperor asked: I have heard that the skin has its own regions, the vessels follow their pathways, the sinews join at particular places, and the bones have set dimensions and forms. The illnesses that arise in them are all different. May I ask where the skin regions lie in relation to left and right, above and below, and Yin and Yang, and how illness arises and develops?

Qibo replied: To understand the regions of the skin, take the channels as your guiding framework. This applies to every channel. Follow the course of each channel and the areas it governs, and you will know the corresponding skin regions. “All the channels” here means the twelve channels; the same principle applies to all twelve.

The Yang collateral associated with the Yangming channel is called “Harm to Flight.” “Flight” means generation and transformation; “harm” refers to the qi of killing and decline. When the qi of killing and decline is in motion, the qi of generation and transformation weakens. This is why it is called “Harm to Flight.”

The method for distinguishing the upper and lower parts is the same: observe the superficial collaterals—the collaterals visible on the skin’s surface—in the area in question, and you can identify those belonging to the Yangming channel. The upper part refers to Hand Yangming, and the lower part to Foot Yangming.

When the superficial collaterals are mostly blue-green, pain is common; when mostly black, impediment disorders—obstructed circulation of qi and blood, with numbness and pain in the limbs—are common. Yellow or red often indicates heat; mostly white indicates cold. If all five colors appear, cold and heat may be mixed. When the collaterals are abundant, pathogenic qi enters and remains in the channels. Yang governs the exterior; Yin governs the interior.

Here, “Yang” means the Yang collaterals, and “Yin” means the Yin collaterals. In general, these statements apply to the channels and collaterals seen in the hands, feet, and throughout the body.

The Yang collateral associated with the Shaoyang channel is called “Pivot and Hold.” “Pivot” means a key point; “hold” means to govern.

The method for distinguishing the upper and lower parts is the same: observe the superficial collaterals in the area in question, and you can identify those belonging to the Shaoyang channel. When the collaterals are abundant, pathogenic qi enters and remains in the channels. Thus, pathogenic qi located in the Yang collaterals invades inward; when located in the Yin collaterals, it manifests outward and seeps inward. The other channels are the same.

The Yang collateral associated with the Taiyang channel is called “Gate and Pivot.” “Gate” means governing the body’s exterior and setting activity in motion; “pivot” is like a door hinge, whose proper movement brings the qi mechanism into harmony. “Gate and Pivot” regulates activity at the body’s surface and keeps the qi mechanism balanced.

The method for distinguishing the upper and lower parts is the same: observe the superficial collaterals in the area in question, and you can identify those belonging to the Taiyang channel. When the collaterals are abundant, pathogenic qi enters and remains in the channels.

The Yin collateral associated with the Shaoyin channel is called “Pivot and Accord.” “Accord” means harmony and ease; it refers to guarding the key point so that the opening and closing functions of Yin and Yang proceed smoothly. The collator adds that in the Jia Yi Jing, “accord” is written as “moistening.”

The diagnostic method is the same for the upper and lower limbs: inspect the area belonging to each region for collateral vessels visible on the skin’s surface. If any are present, they are collaterals of the Lesser Yin channel. When the collaterals become heavily congested, the congestion invades the channels. As it enters the channels, it flows from the Yang aspect into them; when pathogenic Qi moves outward, it flows inward from the Yin aspect toward the bones. When the Yin aspect of the channel governed by the Heart is affected, this is called “shoulder injury.”

The channel governed by the Heart enters beneath the armpit. If the movement of Qi is disordered, it can hinder movement of the shoulder and armpit.

The diagnostic method is the same for the upper and lower limbs: inspect the relevant area for superficial collaterals. If any are present, they are collaterals of the Heart-governed channel. When the collaterals become heavily congested, the congestion invades the channels and then enters the Yin aspect of the Greater Yin channel. This is called “closing and hibernating.” The term describes sealing away and lying dormant, allowing movement to become smooth again and the condition to return to its internal resting state. The New Textual Correction says that the A-B Classic of Acupuncture and Moxibustion writes “hibernating” as “holding.”

The diagnostic method is the same for the upper and lower limbs: inspect the relevant area for superficial collaterals. If any are present, they are collaterals of the Greater Yin channel. When the collaterals become heavily congested, the congestion invades the channels.

Here, “region” always refers to the area through which the collaterals of each channel are distributed; “superficial” means that the vessels are visible on the skin’s surface.

The areas through which the collaterals of the twelve channels are distributed all lie on the skin. Yin and Yang channels each occupy their own area and govern the corresponding skin, which is why these areas are called the “regions of the skin.”

Thus, when any illness first begins, pathogenic Qi must first attack the skin and body hair. Once it enters the skin, the interstices open. When they open, pathogenic Qi enters the collaterals; if it remains there, it passes into the channels. If it remains there as well, it passes into the organs and viscera, where it accumulates in the intestines and stomach. “Granary” means accumulation or gathering.

When pathogenic Qi first enters the skin, a person suddenly feels cold, the body hair stands on end, and the interstices open. Here, “suddenly chilled” means feeling cold; “rising” refers to the body hair standing on end and the skin tightening. The interstices include the spaces and lines in the skin.

After pathogenic Qi enters the collaterals, they become full and their color changes. “Full” means that the vessels are congested; “changes” means that their color differs from normal.

After pathogenic Qi enters the channels, it sinks into them if it encounters weakness there. A channel must be deficient for pathogenic Qi to invade it easily; when the Qi in the vessels is insufficient, the pathogenic Qi sinks inward.

When pathogenic Qi remains between the sinews and bones, an excess of Cold causes the sinews and vessels to contract and the joints to ache. An excess of Heat causes them to slacken, the bones to waste away, and the muscles to grow thin; the raised parts of the flesh break down, and the body hair stands straight and loses its luster. “Contract” means to tighten; “slacken” means to loosen. Both “waste away” and “dwindle” mean to diminish. The Acupuncture Classic says that Cold makes the sinews and vessels contract, while Heat makes them slacken; an excess of Cold causes pain, while an excess of Heat depletes the body’s Qi. “Raised parts” refers to the bulging areas of muscle, which also break down as the muscles grow thin. The original annotation notes that the character for “raised parts” is pronounced qú yǔn.

The Yellow Emperor asked, “You have said that the skin is divided into twelve regions. When illness arises in these regions, what does it look like in each?” Qibo replied, “The skin is the region through which the channels are distributed.”

Qi and Blood flow through the vessels, each with its own Yin-Yang aspect. When Qi reaches a part of the body traversed by a channel, that corresponding part governs its passage; this is why it is called the “section of the vessel.”

When pathogenic Qi invades the skin, the skin’s couli—the skin’s texture and pores—open. Once the couli open, pathogenic Qi enters and lodges in the collateral vessels. When the collaterals are filled with pathogenic Qi, it flows into the channels. When the channels are filled as well, pathogenic Qi enters and lodges in the fu and zang organs. The skin therefore has distinct regions, and if these regions cannot harmonize with the channels, severe illness will result.

The channels run through the skin, each with its own area of distribution. When pathogenic Qi attacks a channel, it travels along that channel and causes illness; illness is not caused by the Qi of the skin itself.

The Newly Collated Edition says: According to the Jia Yi Jing, the character “yu” here should be read as “heal”; the Quan Yuanyi edition has “and.” Quan Yuanyi explains that the passage means that when the skin and channels cannot harmonize, the Qi at the body’s surface is impaired, external pathogens flow inward, and severe illness is certain to follow.

The Yellow Emperor said, “Well said.”

Treatise on the Channels and Collaterals

The Yellow Emperor asked, “When the collateral vessels show at the body’s surface, they appear in different colors—blue-green, yellow, red, white, and black. Why is this?”

Qibo replied, “The colors of the channels follow a regular pattern, but those of the collateral vessels often change. The channels carry Qi, so the colors they show generally correspond to the seasons. The collaterals govern Blood, and their colors change under the influence of pathogenic Qi; they cannot be explained by one rule.”

The Yellow Emperor asked, “What colors do the channels generally show?”

Qibo said, “The Heart channel is red, the Lung channel white, the Liver channel blue-green, the Spleen channel yellow, and the Kidney channel black. Each color corresponds to the nature of its channel.”

The Yellow Emperor asked, “Does the distinction between Yin and Yang in the collateral vessels also correspond to the channels?”

Qibo said, “The color of a Yin collateral matches that of its corresponding channel. The color of a Yang collateral varies and changes with the four seasons.”

In other words, the color of a Yang collateral responds to the seasonal transformations of Qi.

When cold is strong, Blood tends to congeal, and its color appears blue-black. When heat is strong, Blood becomes thin and fluid, and its color appears yellow-red. These are common changes in color and do not indicate illness. If all five colors—blue-green, yellow, red, white, and black—appear at the same time, this indicates that cold and heat are both present within the body.

“Nao” means moist, while “ze” means moist and glossy, or containing fluid. Here, the phrase refers to being slightly moist.

The Yellow Emperor said, “Well said.”

Treatise on Qi Points

The Yellow Emperor asked, “I have heard that there are 365 Qi points, corresponding to the number of days in a year. I do not yet know their exact locations. Please tell me about them in detail.”

Qibo performed a formal bow and bowed twice before replying, “What a profound question! If not a sage ruler, who could fully investigate its principles? Allow me to explain as fully as I can and describe the locations of all the Qi points.”

“Shu” means “who.”

The Yellow Emperor clasped his hands and stepped back slightly. “You have opened this path of inquiry for me. I have not yet seen the locations of the Qi points or heard their number, yet my eyes already seem brighter, and my ears seem to hear more clearly.”

Bright eyes, keen ears, clear speech, and a mind that understands things plainly: one can also act as one wishes.

Qibo said, “This is what is meant by saying that a sage is easy to communicate with and a fine horse is easy to drive.”

The Yellow Emperor said, “I am not as easy to communicate with as a sage. People say that explaining the true principles of medicine enables others to grasp their meaning. The principles I have asked you about so far can indeed enlighten the confused and dispel doubts, but they are not yet enough to discuss the profound principles of medicine.

“Explaining precisely the principles of Qi points—the points where channel Qi gathers and where acupuncture and moxibustion are applied—may perhaps dispel confusion and doubts, but it still does not convey the subtle meaning. Even so, I hope you will speak freely and explain all of this so that I may understand its principles. I will keep it safely in the Golden Coffer, where important texts are stored, and will not bring it out for public circulation again.”

“To explain their locations” means to describe where the points are situated.

Qibo bowed once more, then rose and said, “I will explain. For pain linking the back and the region of the heart, treatment may be applied at Tiantu, the tenth vertebra, and Shangji.

“Tiantu is below the laryngeal prominence, four body inches down, in the central hollow. It is where the Yin Linking Vessel and the Conception Vessel meet. The needle should be inserted at a downward angle; it may be inserted one inch and retained for seven exhalations. If moxibustion is used, apply three cones. Note: In the present versions of the Jia Yi Jing, the Treatise on the Circulation of the Channels, and the Illustrated Canon of Acupoints, no point is listed below the tenth vertebra. The text here may instead mean the seventh vertebra. This is where Shangji, governed by the Qi of the Governing Vessel, is located; it will be discussed below.”

The editor notes: The Jia Yi Jing states that Tiantu is five inches below the laryngeal prominence.

“Shangji” refers to the stomach region, that is, Zhongwan. “Wan” means the stomach. Zhongwan lies one inch below Shangwan, between the xiphoid process and the navel. It is where the three vessels of Hand Taiyang, Hand Shaoyang, and Foot Yangming originate, and where the Qi of the Conception Vessel emerges. The needle may be inserted one inch and two fen. If moxibustion is used, apply seven cones. The editor notes: The Jia Yi Jing identifies it as a meeting point of the Conception Vessel.

“Xiaji” refers to Guanyuan. Guanyuan is the Front-Mu point of the Small Intestine, where the Qi of an organ gathers on the chest or abdomen. It lies three inches below the navel and is where the three Yin channels of the foot meet the Conception Vessel. The needle may be inserted two inches and retained for seven exhalations. If moxibustion is used, apply seven cones.

When pathogenic Qi in the back connects with that in the chest, affecting both the Yin and Yang sides, symptoms may include pain in the front and back, pain in the chest and ribs, difficulty breathing, inability to lie down, Qi surging upward, shortness of breath, or pain on one side of the body. In such cases, treat at the points described above. The editor notes: Another version reads “fullness” in place of “pain on one side.”

This channel of circulation runs obliquely upward from the coccygeal region, connecting along the way with the flanks. A branch leads to the heart, passes through the diaphragm, and ascends to the shoulder. It passes through Tiantu (the point in the hollow above the sternum at the front of the neck), then runs obliquely downward and joins other channels near the tenth thoracic vertebra.

According to the text, the areas traversed by these collateral branches and the related disorders all belong to the collateral network of the Governing Vessel. It branches off at the coccyx, runs obliquely upward to connect with the flanks, and sends a branch to the heart that passes through the diaphragm and ascends to Tiantu. It then runs obliquely down across the shoulder and finally joins the other channels at the tenth thoracic vertebra. The New Collation notes that, given the statement “the back connects with the heart, and pain draws toward this point,” this passage may originally have belonged to “On Bone Hollows” (Gukong Lun), and that text here may be missing or corrupted.

The Fifty Acupoints of the Five Viscera

Here, “Five Viscera” means the liver, heart, spleen, lungs, and kidneys; it does not include other organs considered viscera. “Shu” refers to the five categories of points—Jing-Well, Ying-Spring, Shu-Stream, Jing-River, and He-Sea—not the Back-Shu points.

The following uses the Foot Jueyin Liver Channel as an example and lists its five categories of points:

• Jing-Well point: Dadun, at the tip of the great toe, near the corner of the toenail. It lies within an area about the size of a leek leaf, at the three hairs at the toe’s tip. This is where the Foot Jueyin channel issues forth. The needle may be inserted three fen and retained for ten breaths; alternatively, three moxa cones may be applied.
• Ying-Spring point: Xingjian, between the great toe and second toe, in the hollow where a pulse can be felt under pressure. This is where the Foot Jueyin channel flows. The needle may be inserted three fen and retained for ten breaths; alternatively, three moxa cones may be applied. The New Collation notes that the Jia Yi Jing reads “flow” instead of “retain” here, and that other related passages also have variant readings.
• Shu-Stream point: Taichong, in the hollow two cun behind the base joint of the great toe. The New Collation cites a note to “On Needling Back Pain” to add that the point is in the hollow on the inner side behind the joint, where a pulse can be felt. This is where the Foot Jueyin channel pours in. The needle may be inserted three fen and retained for ten breaths; alternatively, three moxa cones may be applied.
• Jing-River point: Zhongfeng, in the hollow one and a half cun in front of the inner ankle. The New Collation notes that the Jia Yi Jing gives the distance as one cun. To locate the point, raise the foot; it can be found when the foot is extended. This is where the Foot Jueyin channel passes through. The needle may be inserted four fen and retained for seven breaths; alternatively, three moxa cones may be applied.
• He-Sea point: Ququan, in the hollow on the inner side of the knee, below the auxiliary bone, above the large tendon, and below the small tendon. Locate it with the knee bent. This is where the Foot Jueyin channel converges.

“Body-proportioned cun” refers to a unit of measurement based on the recipient’s own body proportions. “Retaining the needle for a certain number of breaths” means counting the breaths taken while the needle remains in place after insertion. “Three moxa cones” means applying moxa three times.

The Jing-Well point of the Pericardium channel is Zhongchong, the Ying-Spring point is Laogong, the Shu-Stream point is Daling, the Jing-River point is Jianshi, and the He-Sea point is Quze.

Zhongchong is at the tip of the middle finger, about the width of a chive leaf from the corner of the nail, in the depression there. It is where the channel Qi of the Hand Jueyin Pericardium channel emerges. A needle may be inserted one proportional body-inch (a measurement for locating points based on the proportions of the patient’s own body), and retained for three breaths; alternatively, one moxa cone may be burned.

Laogong is in the center of the palm, where the palmar artery pulsates. It is where the channel Qi of the Pericardium channel flows. A needle may be inserted three proportional body-inches and retained for six breaths; alternatively, three moxa cones may be burned.

Daling is behind the wrist, in the depression between two tendons. It is where the channel Qi of the Pericardium channel gathers. A needle may be inserted six proportional body-inches and retained for seven breaths; alternatively, three moxa cones may be burned.

Jianshi is three proportional body-inches behind the wrist, in the depression between two tendons. It is where the channel Qi of the Pericardium channel passes through. A needle may be inserted six proportional body-inches and retained for seven breaths; alternatively, seven moxa cones may be burned. A note in the revised edition states that the Jia Yi Jing records three moxa cones for this point.

Quze is in the depression below the transverse crease on the inner side of the elbow. Locate it with the elbow bent. It is where the channel Qi of the Pericardium channel enters. A needle may be inserted three proportional body-inches and retained for seven breaths; alternatively, three moxa cones may be burned.

The Jing-Well point of the Spleen channel is Yinbai, the Ying-Spring point is Dadu, the Shu-Stream point is Taibai, the Jing-River point is Shangqiu, and the He-Sea point is Yinlingquan.

Yinbai is on the inner side of the tip of the big toe, about the width of a chive leaf from the corner of the nail. It is where the channel Qi of the Foot Taiyin Spleen channel emerges. A needle may be inserted one proportional body-inch and retained for three breaths; alternatively, three moxa cones may be burned.

Dadu is in the depression behind the joint at the base of the big toe. It is where the channel Qi of the Spleen channel flows. A needle may be inserted three proportional body-inches and retained for seven breaths; alternatively, three moxa cones may be burned.

Taibai is on the inner side of the foot, in the depression below the prominence of the first metatarsal bone. It is where the channel Qi of the Spleen channel gathers. A needle may be inserted three proportional body-inches and retained for seven breaths; alternatively, three moxa cones may be burned.

Shangqiu is in a depression slightly forward of and below the inner ankle bone. It is where the channel Qi of the Spleen channel passes through. A needle may be inserted four proportional body-inches and retained for seven breaths; alternatively, three moxa cones may be burned.

Yinlingquan is at…

On the inner side below the knee, in the hollow beneath the supporting bone, which can be found only when the leg is straightened. This is the point where the Foot Taiyin channel enters. The needle may be inserted five fen and retained for seven breaths; alternatively, three cones of moxa may be applied.

The well point of the Lung channel is Shaoshang, the spring point is Yuji, the stream point is Taiyuan, the river point is Jingqu, and the sea point is Chize.

Shaoshang is on the inner side of the tip of the thumb, about the width of a leek leaf from the corner of the nail. It is where the Hand Taiyin channel emerges. The needle may be inserted one fen and retained for one breath; alternatively, three cones of moxa may be applied. The New Collation says that the Jia Yi Jing records one cone of moxa.

Yuji is on the inner side behind the joint at the base of the thumb, where the network of vessels spreads. It is where the Hand Taiyin channel flows and gathers. The needle may be inserted two fen and retained for three breaths; alternatively, three cones of moxa may be applied.

Taiyuan is in the hollow behind the wrist. It is where the Hand Taiyin channel converges. The needle may be inserted two fen and retained for two breaths; alternatively, three cones of moxa may be applied.

Jingqu is in the hollow at the cun pulse. It is where the Hand Taiyin channel passes along its course. The needle may be inserted three fen and retained for three breaths. Moxibustion must not be used there, lest the person’s spirit be harmed.

Chize is in the elbow crease, at the pulsating artery above the crease. It is where the Hand Taiyin channel converges. The needle may be inserted three fen and retained for three breaths; alternatively, three cones of moxa may be applied.

The well point of the Kidney channel is Yongquan, the spring point is Rangu, the stream point is Taixi, the river point is Fuliu, and the sea point is Yingu. The New Collation says that in the Jia Yi Jing, the character liu in “Fuliu” is written liu meaning “remain”; the same applies to the other occurrences of liu.

Yongquan is in the hollow in the sole of the foot: when the foot is bent and the toes curled, a hollow appears in the sole. It is where the Foot Shaoyin channel emerges. The needle may be inserted three fen and retained for two breaths; alternatively, three cones of moxa may be applied.

Rangu is in the hollow beneath the large bone, in front of the inner ankle. It is where the Foot Shaoyin channel flows and gathers. The needle may be inserted three fen and retained for three breaths; alternatively, three cones of moxa may be applied. Needling this point often causes bleeding, after which the person soon feels hungry and wants to eat.

Taixi is in the hollow at the artery behind the inner ankle and above the heel bone. It is where the Foot Shaoyin channel converges. The needle may be inserted three fen and retained for seven breaths; alternatively, three cones of moxa may be applied.

The original text breaks off at “Fuliu is on the foot”; the remainder is missing.

Two body inches above the inner ankle, in the hollow, is where the Foot Shaoyin channel passes. The needle may be inserted three body inches and retained for three breaths; alternatively, five moxa cones may be applied.

Yingu lies below the knee, behind the inner supporting bone, beneath the large tendon and above the small tendon. It can be felt by pressing, and is easier to locate when the knee is bent. This is where the Foot Shaoyin channel enters. The needle may be inserted four body inches; alternatively, three moxa cones may be applied.

Each of the five Zang organs has five Shu points, making twenty-five in all. Counting the points on both the left and right sides gives fifty.

The Shu points of the six Fu organs total seventy-two. Here, “Fu” refers to the six Fu organs, not other categories of Fu. “Shu” refers to the six classes of points: Jing-Well, Ying-Spring, Shu-Stream, Yuan-Source, Jing-River, and He-Sea—not the Shu points on the back.

Take the Gallbladder, the Fu organ associated with the Liver, as an example. Its six points are: the Jing-Well point Qiaoyin, the Ying-Spring point Xiaxi, the Shu-Stream point Linqi, the Yuan-Source point Qiuxu, the Jing-River point Yangfu, and the He-Sea point Yanglingquan.

Qiaoyin lies at the tip of the second toe beside the little toe, about the width of a leek leaf from the corner of the nail. It is where the Foot Shaoyang channel begins. The needle may be inserted one body inch and retained for one breath. The Jiayi Jing records a retention time of three breaths. Alternatively, three moxa cones may be applied.

Xiaxi lies in the web between the second and third toes beside the little toe, in the hollow near the front of the joint. It is where the Foot Shaoyang channel flows. The needle may be inserted three body inches and retained for three breaths; alternatively, three moxa cones may be applied.

Linqi lies in the hollow behind the joint of the second toe beside the little toe, one and a half inches from Xiaxi. It is where the Foot Shaoyang channel gathers and pours in. The needle may be inserted three body inches. The Jiayi Jing records an insertion depth of two body inches and a retention time of five breaths. Alternatively, three moxa cones may be applied.

Qiuxu lies in the hollow on the front side below the outer ankle, three inches from Linqi. It is where the Foot Shaoyang channel passes. The needle may be inserted five body inches and retained for seven breaths; alternatively, three moxa cones may be applied.

Yangfu lies above the outer ankle… The New Collation notes that, according to the Jiayi Jing, its location is above the outer ankle…

Four cun anterior to the tip of the fibula, locate the point in the same way described above. It is seven cun from Qiuxu and is where the Foot Shaoyang channel passes. The needle may be inserted five fen and retained for seven breaths; three moxa cones may be applied.

Yanglingquan lies about one cun below the knee, in the hollow on the outer side of the shinbone. It is the point where the Foot Shaoyang channel enters. The needle may be inserted six fen and retained for ten breaths; three moxa cones may be applied.

The Jing-Well point of the Stomach is Lidui, the Ying-Spring point is Neiting, the Shu-Stream point is Xiangu, the Yuan-Source point is Chongyang, the Jing-River point is Jiexi, and the He-Sea point is Zusanli.

Lidui lies at the tip of the second toe, near the outer corner of the toenail, about the width of a chive leaf from it. It is the starting point of the Foot Yangming channel. The needle may be inserted one fen and retained for one breath; one moxa cone may be applied.

Neiting lies in the hollow between the second and third toes. It is the point where the Foot Yangming channel flows onward. The needle may be inserted three fen and retained for ten breaths. The New Textual Correction says: The Jiayi Jing records that the needle should be retained for twenty breaths. Three moxa cones may be applied.

Xiangu lies between the second and third toes, in the hollow behind the metatarsophalangeal joint. It is two cun from Neiting and is the point where the Foot Yangming channel pours into. The needle may be inserted five fen and retained for seven breaths; three moxa cones may be applied.

Chongyang lies on the top of the foot, about five cun from the ankle, over the artery between the two bones. It is three cun from Xiangu and is where the Foot Yangming channel passes. The needle may be inserted three fen and retained for ten breaths; three moxa cones may be applied.

Jiexi lies behind Chongyang. The original text gives its distance from Chongyang as two and a half cun. The New Textual Correction notes that the Jiayi Jing gives one and a half cun, the “Commentary on Acupuncture for Malaria” gives three and a half cun, and the two commentaries in the Suwen also disagree. It concludes that the Jiayi Jing reading should be followed. This point lies in the hollow above the ankle and is where the Foot Yangming channel runs through. The needle may be inserted five fen and retained for five breaths; three moxa cones may be applied.

Zusanli lies three cun below the knee, on the outer side of the shinbone between two muscles. It is the point where the Foot Yangming channel enters. The needle may be inserted…

The depth of insertion is one cun, and the needle is retained for seven breaths. If moxibustion is used, apply three moxa cones.

The Large Intestine is the bowel associated with the Lungs. The Jing-Well point of the Large Intestine channel is Shangyang; its Ying-Spring point is Erjian, its Shu-Stream point is Sanjian, its Yuan-Source point is Hegu, its Jing-River point is Yangxi, and its He-Sea point is Quchi.

Shangyang is on the thumb side of the index finger, about the width of a chive leaf from the corner of the nail. It is where the Hand Yangming channel (the Hand Yangming Large Intestine channel) begins. The needle may be inserted one fen, measured in proportional cun based on the patient’s own body, and retained for one breath. Alternatively, apply three moxa cones.

Erjian is in the hollow on the thumb side of the index finger, just in front of the finger’s main joint. It is where the Hand Yangming channel passes through. The needle may be inserted three fen and retained for six breaths. Alternatively, apply three moxa cones.

Sanjian is in the hollow on the thumb side of the index finger, just behind the finger’s main joint. It is where the Hand Yangming channel pours in. The needle may be inserted three fen and retained for three breaths. Alternatively, apply three moxa cones.

Hegu is between the bones at the fork where the thumb and index finger meet. It is where the Hand Yangming channel passes. The needle may be inserted three fen and retained for six breaths. Alternatively, apply three moxa cones.

Yangxi is in the hollow on the upper side of the wrist, between two tendons. It is where the Hand Yangming channel moves onward. The needle may be inserted three fen and retained for seven breaths. Alternatively, apply three moxa cones.

Quchi is in the hollow on the outer side of the elbow, between the two bones when the elbow is bent. It is where the Hand Yangming channel converges. To locate the point, bend the arm and raise the palm toward the chest. The needle may be inserted five fen and retained for seven breaths. Alternatively, apply three moxa cones.

The Small Intestine is the bowel associated with the Heart. The Jing-Well point of the Small Intestine channel is Shaoze; its Ying-Spring point is Qiangu, its Shu-Stream point is Houxi, its Yuan-Source point is Wangu, its Jing-River point is Yanggu, and its He-Sea point is Shaohai.

Shaoze is in the hollow at the tip of the little finger, one proportional fen below the nail. It is where the Hand Taiyang channel (the Hand Taiyang Small Intestine channel) begins. The needle may be inserted one fen and retained for two breaths. Alternatively, apply one moxa cone.

Qiangu is in the hollow on the outer side of the little finger, just in front of its main joint. It is where the Hand Taiyang channel passes through. The needle may be inserted one fen and retained for three breaths. Alternatively, apply three moxa cones.

Houxi is in the hollow on the outer side of the little finger, just behind its main joint. It is where the Hand Taiyang channel pours in. The needle insertion depth is one proportional fen.

The Wangu point lies on the outer side of the wrist, in the hollow below the prominent bone at the front of the wrist. The Hand Taiyang channel passes through this point. The needle may be inserted two fen and retained for three breaths; one moxa cone may also be applied.

The Yanggu point lies on the outer side of the wrist, in the hollow below the sharp wrist bone. The Hand Taiyang channel flows through this point. The needle may be inserted two fen and retained for three breaths. A textual note in the revised edition says: “The Jia Yi Jing records ‘retain for two breaths.’” Three moxa cones may also be applied.

The Shaohai point lies on the outer side of the large bone on the inner elbow, in a hollow five fen from the tip of the elbow. It can be located when the elbow is bent and is where the Hand Taiyang channel enters and joins. The needle may be inserted two fen and retained for seven breaths; five moxa cones may also be applied.

The Fu of the Pericardium channel is the Sanjiao. The Jing-Well point of the Sanjiao channel is Guanchong, its Ying-Spring point is Yemen, its Shu-Stream point is Zhongzhu, its Yuan-Source point is Yangchi, its Jing-River point is Zhigou, and its He-Sea point is Tianjing. Here, “Jing-Well,” “Ying-Spring,” “Shu-Stream,” “Yuan-Source,” “Jing-River,” and “He-Sea” are categories of points along the channels.

The Guanchong point lies at the tip of the finger beside the little finger, about the width of a leek leaf from the corner of the nail. It is where the Hand Shaoyang channel emerges. The needle may be inserted one fen and retained for three breaths; three moxa cones may also be applied.

The Yemen point lies in the hollow between the fingers, beside the little finger. It is where the Hand Shaoyang channel flows. The needle may be inserted two fen and retained for two breaths; three moxa cones may also be applied.

The Zhongzhu point lies in the hollow between two bones, behind the metacarpophalangeal joint of the finger beside the little finger. It is where the Hand Shaoyang channel gathers and pours through. The needle may be inserted two fen and retained for three breaths; three moxa cones may also be applied.

The Yangchi point lies in a hollow on the back of the wrist. The Hand Shaoyang channel passes through this point. The needle may be inserted two fen and retained for six breaths; three moxa cones may also be applied.

The Zhigou point lies three cun behind the wrist, in a hollow between two bones. The Hand Shaoyang channel flows through this point. The needle may be inserted two fen and retained for seven breaths; three moxa cones may also be applied.

The Tianjing point lies one cun behind the large bone on the outer elbow, in a hollow between two tendons. It can be located when the elbow is bent and is where the Hand Shaoyang channel enters and joins. The needle may be inserted one cun and retained for seven breaths; if moxibustion is applied…

The urinary bladder is the fu organ of the kidneys. The Bladder Channel has six points in the Five Shu categories, including the source point: the Jing-Well point Zhiyin, the Ying-Spring point Tonggu, the Shu-Stream point Shugu, the source point Jinggu, the Jing-River point Kunlun, and the He-Sea point Weizhong.

Zhiyin is on the outer side of the little toe, about a leek-leaf’s width from the corner of the toenail. It is where the Foot Taiyang channel emerges. Needling may reach one cun (a measurement based on the patient’s own body proportions), with the needle retained for five breaths. Alternatively, apply three moxa cones, each made from a single portion of moxa wool.

Tonggu is on the outer side of the little toe, in the hollow in front of the joint at its base. It is where the qi of the Foot Taiyang channel flows. Needling may reach two fen, with the needle retained for five breaths; alternatively, apply three moxa cones.

Shugu is on the outer side of the little toe, in the hollow behind the joint at its base, where the red and white skin meet. It is where the qi of the Foot Taiyang channel pours in. Needling may reach three fen, with the needle retained for three breaths; alternatively, apply three moxa cones.

Jinggu is in the hollow below the large bone on the outer side of the foot, where the red and white skin meet. It can be located by pressing. It is where the Foot Taiyang channel passes. Needling may reach three fen, with the needle retained for seven breaths; alternatively, apply three moxa cones.

Kunlun is in the hollow behind the outer ankle and above the heel bone, where a faint pulse can be felt. It is where the qi of the Foot Taiyang channel moves. Needling may reach five fen, with the needle retained for ten breaths; alternatively, apply three moxa cones.

Weizhong is in the center of the hollow behind the knee, where a pulse can be felt in the crease. The revised commentary states that the location of Weizhong agrees with the Jia Yi Jing and the commentaries to “Treatise on Needling Malaria” and “Treatise on Bi Syndrome.” “Treatise on Bone Hollows” places it behind the knee joint, in the hollow that appears when the leg is bent, and says to locate it from the back of the leg. The commentaries to “Treatise on Heat Points” and “Treatise on Needling Heat” likewise place it in the hollow behind the knee when the knee is bent. Weizhong is where the Foot Taiyang channel converges. Needling may reach five fen, with the needle retained for seven breaths; alternatively, apply three moxa cones.

Thus, each of the six fu organs has six shu points—points where the qi and blood of the channels flow, pass through, or converge—making thirty-six points in total. Counting the points on both the left and right sides gives seventy-two.

There are fifty-nine shu points for treating heat disorders and fifty-seven for treating water disorders; these are described in detail in “Treatise on Water and Heat.” The revised commentary notes that the points for treating heat disorders are also listed in the commentary to “Treatise on Needling Heat.”

On the head, five rows are arranged with five points in each row, for a total of twenty-five points. These are also included among the fifty-nine points for treating heat disorders. There are five points on each side of the central area, ten in all. The written form of “central area” appears to be corrupt.

Feishu, Xinshu, Ganshu, Pishu, and Shenshu are the back points corresponding to the five zang organs—the points selected for acupuncture treatment. Feishu lies on either side below the third thoracic vertebra; Xinshu below the fifth; Ganshu below the ninth; Pishu below the eleventh; and Shenshu below the fourteenth. Each point is about one and a half cun from the spine, with the cun measured according to the patient’s own body proportions. These points are also places where the Foot Taiyang meridian converges. The needling depth is about three fen. Retain the needle for six breaths at Ganshu and seven breaths at each of the other points. If using moxibustion, apply three cones of moxa at each point. There are five pairs of points, one on each side, making ten in all.

There is one point on each side above Dazhui, two in all. However, books such as the Jia Yi Jing, the Jingmai Liuzhu, and the Kongxue Tujing do not record them, so it is unclear what points they are. The New Corrected Edition argues that there are no points on either side above Dazhui. The points on either side below Dazhui are called Dazhu; this, it says, is why Wang Bing remarked that it was unclear which points were meant.

Tongziliao and Fubai are two points. Tongziliao lies beside the outer corner of the eye, about five fen from the corner, where the Hand Taiyang, Hand Shaoyang, and Foot Shaoyang meridians converge. The needling depth is about three fen; if using moxibustion, apply three cones. Fubai lies one cun within the hairline behind the ear, where the Foot Taiyang and Foot Shaoyang meridians converge. The needling depth is about three fen; if using moxibustion, apply three cones. There is one point on each side, four in all.

There is one point on each side in the hollows near the hip joints, referring to Huantiao. It lies behind the bìshū, the area where the hip joint turns, and is where the Foot Shaoyang and Foot Taiyang meridians converge. Needle to a depth of about one cun and retain the needle for two breaths; if using moxibustion, apply three cones. The New Corrected Edition notes that Wang Bing’s commentary says “behind the bìshū,” while the Jia Yi Jing gives “in the bìshū” and considers “in” the correct reading. For moxibustion, the Jia Yi Jing specifies five cones.

There is one Dubi point on each side. It lies below the kneecap and above the lower leg, between the two large tendons, where the Qi and blood of the Foot Yangming meridian are conveyed. The needling depth is about six fen; if using moxibustion, apply three cones.

There is a “Duosuo Wen” point in each ear, referring to Tinggong. It lies near the tragus inside the ear, and the point is about the size of a red bean. It is where the Hand Shaoyang, Foot Shaoyang, and Hand Taiyang meridians converge. The needling depth is about one fen; if using moxibustion, apply three cones.

The Yi Jing says that the needle may be inserted three fen here.

Two Meiben Points

Meiben is the Cuanzhu point. It lies in the hollow at the inner end of the eyebrow, where the Qi and blood of the Foot Taiyang channel gather and emerge. The needle may be inserted three body-inch fen, and retained for six breaths. For moxibustion, three cones may be applied.

Two Wangu Points

The Wangu point lies behind the ear, four body-inch fen from the hairline. It is where the Foot Taiyang and Foot Shaoyang channels meet. The needle may be inserted three body-inch fen, and retained for seven breaths. For moxibustion, three cones may be applied. The New Collation says that the Jia Yi Jing records a needle depth of three fen and seven cones of moxibustion.

One Point at the Center of the Nape

The point at the center of the nape is Fengfu. It lies one body inch inside the hairline at the back of the neck, in the hollow between the two large tendons. It is where the Governing Vessel and the Yang Linking Vessel meet. When a person speaks rapidly, the muscles at the point bulge; when they stop speaking, the muscles sink back down. The needle may be inserted four body-inch fen, and retained for three breaths. Moxibustion may cause loss of voice.

Two Zhen’gu Points

The Zhen’gu point is Qiaoyin. It lies above Wangu and below the occipital bone. When the head is turned, movement can be felt beneath the hand. It is where the Foot Taiyang and Foot Shaoyang channels meet. The needle may be inserted three body-inch fen. For moxibustion, three cones may be applied. The New Collation says that the Jia Yi Jing records a needle depth of four fen and five cones of moxibustion.

Two Shangguan Points

The point described in the Needling Classic as one that, when needled, prevents the mouth from opening to yawn is Shangguan. It lies above the front of the ear, along the edge of the bone. A hollow appears there when the mouth is opened. It is where the Hand Shaoyang and Foot Yangming channels meet. The needle may be inserted three body-inch fen, and retained for seven breaths. For moxibustion, three cones may be applied. If the needle is inserted too deeply, the person may lose the ability to hear.

Two Daying Points

The Daying point lies in front of the bend of the lower jaw, about one body inch and three fen away, in a hollow along the edge of the bone where the artery pulses. It is where the Qi and blood of the Foot Yangming channel gather and emerge. The needle may be inserted two body-inch fen, and retained for seven breaths. For moxibustion, three cones may be applied.

Two Xiaguan Points

The point described in the Needling Classic as one that, when needled, allows the mouth to open but not close is Xiaguan. It lies below Shangguan, beneath the artery in front of the ear. A hollow appears there when the mouth is closed and disappears when it is opened. This point is where the Foot Yangming and Foot Shaoyang channels meet. The needle may be inserted three body-inch fen, and retained for seven breaths. For moxibustion, three cones may be applied. If there is dried, hardened discharge in the ear, remove it if possible; do not apply moxibustion. The New Collation says that the Jia Yi Jing also records the instruction to “remove it.”

“Zuo zhai di” (“zhai” is read as “zhai”; “qu” is read as “qiu shu qie”) [pronunciation notes].

Tianzhu points: one on each side, two in all.

They are located at the hairline on the back of the neck, in hollows along the outer edges of the large tendons on either side. They are sites where the Qi and blood of the Foot Taiyang channel are conveyed. A needle may be inserted about two fen (measured in the ancient “body-inch” unit, based on the patient’s own body), and retained for six breaths. Apply three moxa cones.

Shanglian and Xialian points: one on each side, four in all.

Shanglian point: Where the Foot Yangming and Foot Taiyang channels meet. It is located on the outer side of the lower leg, six cun below the hollow on the outer side of the knee (Dubi), along the outer edge of the tibia. It is a site where the Qi and blood of the Foot Yangming channel are conveyed. A needle may be inserted eight fen; apply three moxa cones.

Xialian point: Where the Foot Yangming and Foot Shaoyang channels meet. It is located three cun below the Shanglian point. It is a site where the Qi and blood of the Foot Yangming channel are conveyed. A needle may be inserted three fen; apply three moxa cones.

[The New Collation notes:] According to the Jia Yi Jing and the commentaries on the “Treatise on Needling Heat” and the “Treatise on Water and Heat Points” in the Suwen, the Shanglian point is three cun below the Zusanli point. Its location is given here as six cun below the Dubi point because Zusanli is three cun below Dubi, and Shanglian is another three cun below Zusanli, making six cun altogether.

Quya points: one on each side, two in all.

These are also called Jiache points. They are located in the hollows below the ears, near the angles of the jaw; the hollows can be felt when the mouth is open. They are sites where the Qi and blood of the Foot Yangming channel are conveyed. A needle may be inserted three fen; apply three moxa cones.

Tiantu point: one point in all.

It has already been explained above.

Tianfu point: one point in all.

It is located three cun below the armpit, over the artery on the inner side of the upper arm. It is a site where the Qi and blood of the Hand Taiyin channel are conveyed. Moxibustion is prohibited. A needle may be inserted four fen and retained for three breaths. “Nao” is pronounced “nu dao qie.”

Tianyou points: one on each side, two in all.

They are located between the muscles of the neck, above the Quepen, behind the Tianrong, in front of the Tianzhu, and below the Wan Gu, at the hairline. They are sites where the Qi and blood of the Hand Shaoyang channel are conveyed. A needle may be inserted one cun and retained for seven breaths; three moxa cones may be applied.

Futu point: one point in all.

It is located one cun below the bend of the neck and behind the Renying point. To locate it, raise the head. It is a site where the Qi and blood of the Hand Yangming channel are conveyed. A needle may be inserted four fen; three moxa cones may be applied.

Tianchuang points: one on each side, two in all.

They are located below the bend of the neck and behind the Futu point, in a hollow where the pulse can be felt under the hand. The original text breaks off here.

For the points where the Qi and blood of the Yang channels flow and that can be needled, the needling depth is six fen (measured in body inches according to the patient’s own proportions). If moxibustion is used, apply three cones (one burning of a moxa cone is called one cone).

Two Shoulder Junction Points

This refers to the Jianjing points, located in the hollows atop the shoulders, above the supraclavicular fossae (the hollows above the collarbones) and in front of the large bones. They are where the Hand Shaoyang, Foot Shaoyang, and Yang Linking Vessel meet. Needle to a depth of five body inches; if using moxibustion, apply three cones.

The Newly Corrected Edition says: According to the Jia Yi Jing, this point should receive five cones of moxibustion.

One Guanyuan Point

The Newly Corrected Edition says: On close examination, this passage has already been explained above. It should originally have been noted again in this section, but has now been omitted.

Two Weiyang Points

Weiyang is the lower supporting transport point of the Triple Burner. It is located on the outer side of the hollow behind the knee, between the two tendons. It is a separate collateral of the Foot Taiyang channel. Needle to a depth of seven body inches and retain the needle for five breaths (approximately the time it takes the patient to breathe five times). If using moxibustion, apply three cones. Locate the point with the knee bent and extended.

Two Jianzheng Points

These points are in the hollow below the back of the shoulder, between the two bones at the lower part of the scapula, behind the Jianyu point (a point on the shoulder). They are where the Qi and blood of the Hand Taiyang channel flow. Needle to a depth of eight body inches; if using moxibustion, apply three cones.

One Yamen Point

This point is in the hollow at the midline of the nape, at the hairline. It connects deep within to the root of the tongue and is where the Governing Vessel and Yang Linking Vessel meet. Locate it with the head tilted back. Needle to a depth of four body inches. Do not use moxibustion, as it can cause loss of voice.

The Newly Corrected Edition says: According to the Qifu Commentary, this point is one body inch below the Fengfu point.

One Qi Point

This refers to the center of the navel. Needling is forbidden here. Needling can cause a malignant ulcer in the navel, with feces draining from it, and ultimately lead to death; there is no remedy. If using moxibustion, apply three cones.

Twelve Chest Transport Points

These are the six points Yufu, Zhong, Shencang, Lingxu, Shenfeng, and Bulang, one on each side, making twelve in all. Yufu lies below the collarbone, in a hollow two body inches to either side of the Conception Vessel. The five points below it are arranged in sequence, each one body inch and six fen apart, all in hollows. These points all belong to the Foot Shaoyin channel. Locate them with the patient lying on their back. Needle to a depth of four body inches; if using moxibustion, apply five cones.

Two Back Transport Points

This refers to the Dazhu points, located below the spinous process of the first thoracic vertebra, in hollows one and a half body inches to either side of the Governing Vessel. They are where a separate collateral of the Governing Vessel meets the Hand Taiyang and Foot Taiyang channels. Needle to a depth of three body inches and retain the needle…

After inserting the needle, retain it for seven breaths, roughly the time it takes to breathe seven times. If using moxibustion, apply seven cones of moxa, with each burning cone counted as one application.

The Twelve Chest Shu Points

These are Yunmen, Zhongfu, Zhourong, Xiongxiang, Tianxi, and Shidou, one on each side, making twelve points in all. The Collated Corrections notes that the Jia Yi Jing gives the names as “Zhourong and Xiongxiang.”

Yunmen lies below the clavicle, near either side of the Ren vessel, six body inches from the Ren vessel on each side. These inches are measured according to the proportions of the patient’s own body. The Collated Corrections notes that although the location recorded in the Shui Re Xue Zhu differs from the description here, the actual site is the same.

All these points lie in depressions where a pulse can be felt when pressed. Yunmen and Zhongfu are a little more than one inch apart; each of the remaining five points is spaced one inch and six tenths from the next. They are all points where the Qi of the Hand Taiyin channel emerges. To locate Yunmen and Shidou, raise the arm; locate the other points with the patient lying on their back.

Needle Yunmen to a depth of seven fen; needling too deeply may obstruct the person’s breathing. Needle Zhongfu to three fen and retain the needle for five breaths. The other points may be needled to four fen. If using moxibustion, apply five cones.

The Collated Corrections notes that Wang identifies all twelve points as belonging to the Hand Taiyin channel. According to the Jia Yi Jing, however, Yunmen belongs to the Hand Taiyin channel, Zhongfu is where the Hand Taiyin and Foot Taiyin channels meet, and the points from Zhourong onward belong to the Foot Taiyin channel. Therefore, these twelve points do not all belong to the Hand Taiyin channel.

The Two Fenrou Points

The Fenrou point lies above the outer ankle, about three fen from the end of the juegu bone, between the divisions of muscle and tendon. It is a point where the Qi of the Yangwei vessel emerges. Needle it to a depth of three fen and retain the needle for seven breaths. If using moxibustion, apply three cones.

The Collated Corrections notes that the Jia Yi Jing does not record a point called Fenrou. The location described here may refer to Yangfu, which lies above the outer ankle, in front of the fibula, three fen forward from the end of the juegu bone. The Ci Yaotong Zhu also places the point two fen behind the end of the juegu bone, with needling to a depth of five fen and retention for ten breaths; this differs slightly from the description here.

The Two Zao Shangheng Points

The point above the inner ankle is Jiaoxin. It lies two inches above the inner ankle, between the tendon and bone, in front of the Foot Shaoyin channel and behind the Foot Taiyin channel. It is the xi-cleft point of the Foot Yinqiao vessel, where the channel’s Qi and blood gather deeply. Needle it to a depth of four fen and retain the needle for five breaths. If using moxibustion, apply three cones.

The point above the outer ankle is Fuyang. Fuyang lies above the outer ankle…

Three cun above the ankle bone, between the tendons and bones in front of the Foot Taiyang channel and behind the Foot Shaoyang channel, is the Xi point of the Yang Qiao vessel. A Xi point is where channel Qi gathers deeply and can be treated with acupuncture. The needle may be inserted six fen, measured in body proportional cun, and retained for seven breaths. If moxibustion is used, apply three cones of moxa.

The New Revised Text says: On consulting the Jia Yi Jing, the name “Fuyang” is written “Fuyang” with a different character.

The four points of the Yin and Yang Qiao vessels

The Yin Qiao point lies below the inner ankle bone and is called Zhaohai. It is the point from which the Yin Qiao vessel emerges. The needle may be inserted four body proportional fen and retained for six breaths. If moxibustion is used, apply three cones.

The Yang Qiao point is called Shenmai. It is the point from which the Yang Qiao vessel emerges, located in the hollow below the outer ankle bone. The needle may be inserted three body proportional fen and retained for seven breaths. If moxibustion is used, apply three cones.

The New Revised Text says: A note to the “Treatise on Needling for Lumbago” places Shenmai five fen below the outer ankle bone. A note to the “Treatise on Piercing” places it half a cun below the outer ankle bone and says the hollow can hold a fingernail. On consulting the Jia Yi Jing, the instruction to retain the needle for seven breaths is given as six breaths; the note to the “Treatise on Needling for Lumbago” gives ten breaths.

The points for water disorders lie between the muscle striations.

Here, “divisions” refers to the spaces between the divisions of the muscles. To treat water disorders, select points in these places.

The points for treating heat patterns lie at the Qi points.

To drain heat pathogens, select these points.

There are two points for treating alternating chills and fever, in the hollow at the outer side of the knee joint.

“Bone hollow” refers to the depression on the outer side of the knee, near the kneecap.

A point subject to a major prohibition lies five cun below Tianfu.

This refers to the Wuli point. It is called “subject to a major prohibition” because needling this point is forbidden. The Needling Classic says: “When needling Wuli against the flow of channel Qi, needle upward along the channel, and do so no more than five times. Repeatedly needling it five times will exhaust the Qi of the zang-fu organs.” Thus, five times multiplied by five, or twenty-five times, will cause the Qi of the point to run dry; this may be what the text means. It also says that Wuli lies five li behind Chize, in agreement with the account here.

Altogether, there are 365 points used in the course of acupuncture.

The New Revised Text says: A careful count from the fifty points of the zang-fu organs to this passage, including repeated entries, gives 360 points. Adding Tiantu, Shizhui, Shangji, and Xiaji from the preceding text brings the total to 365. After duplicate points are excluded, the actual total is 313.

The Yellow Emperor said: “I now understand the locations of the Qi points and the paths followed by the wandering needle. I would like to ask whether the Sunluo and the Xigu, the hollows between the muscles, also each have corresponding points.”

Qibo replied: “The Sunluo are fine collateral vessels, branches that extend from the larger collaterals. The Sunluo have 365 meeting places, corresponding, too, to the number of days in the year.”

This method drains overflowing pathogenic Qi and restores the smooth flow of Ying and Wei (nutritive Qi and defensive Qi). When Ying and Wei stagnate, defensive Qi disperses and nutritive Qi spills outward; Qi is exhausted and Blood becomes stagnant. Pathogenic Qi on the exterior causes fever, while within it leaves a person short of Qi. Apply draining needling promptly, without delay, to unblock Ying and Wei. Whenever stagnation is found, drain it; there is no need to be bound by the site where pathogenic Qi has gathered.

When nutritive Blood has accumulated and stagnated, defensive Qi is obstructed, and the two bind against each other internally and externally, inspect the blood vessels. If blood stasis is found, drain it at once; there is no need to be bound by the points where the channels converge.

The Yellow Emperor asked, “I would like to understand how the Xigu—the fine spaces and places of convergence between the muscles—come together.” Qibo replied, “The large convergences of muscle are called gu, and the small ones are called xi. The convergences of Xigu between the layers of muscle are where Ying and Wei circulate and where the great Qi—the body’s principal Qi in motion—gathers.”

The Supplementary Commentary to the New Collation says: In the Jia Yi Jing, this passage reads, “where the great Qi is stored.”

When pathogenic Qi overflows and the flow of Qi becomes obstructed, heat arises within the vessels and the flesh decays. Ying and Wei can no longer circulate, and suppuration is inevitable. Within, the bone marrow is eaten away; on the exterior, the thigh breaks open. This occurs because pathogenic heat has become excessive.

When pathogenic Qi remains in the spaces between the joints, decay is inevitable. If it lodges between the bones and joints, where fluids gather, the marrow fluid between the joints will suppurate and decay. The sinews and bones must then deteriorate and rot, making it impossible to bend or extend the limbs.

Accumulated cold lodges in place, preventing Ying and Wei from circulating; the sinews contract and become cramped and rigid.

The Supplementary Commentary to the New Collation says: The edition by Quan Yuanqi reads, “the flesh contracts and the sinews shorten.”

The ribs and elbows cannot extend. Internally, bone Bi disease—a painful obstruction caused by cold penetrating deeply into the joints—develops; externally, sensation is lost. This is called “insufficiency.” It is caused by severe cold lodging in the Xigu.

Pathogenic Qi has become so abundant that the body’s true Qi, its own healthy Qi, can no longer nourish it, and the bone marrow is also depleted. Hence these symptoms arise. The “insufficiency” mentioned here means insufficiency of Yang Qi. Cold invades from outside and remains accumulated for a long time. Yang Qi cannot defend against it at the body’s surface, while internally it depletes the sinews and marrow; this is therefore called “insufficiency.” It is caused by severe cold lodging in the Xigu.

There are 365 convergences of acupoints in the Xigu, corresponding to the number of days in a year. When mild Bi obstruction spreads and wanders along the channels, the method of treating it with fine needles is the same as the standard needling method.

If mild cold spreads and travels along the channels, causing Bi disease, the method of regulating it with needles is likewise the same as the standard needling method.

The Yellow Emperor then dismissed his attendants, rose, and bowed twice. He said, “Now you have clarified the principles and dispelled my doubts. I will keep these teachings in a golden coffer and will not show them lightly to others.” He then stored them in the Chamber of Golden Orchid and titled them “Where the Qi Points Are Located.”

Qibo said, “The Sun Luo are small collateral vessels that branch off from the channels. Among them, 365 vessels are filled with abundant Blood and Qi and require draining. These vessels all converge in the collateral vessels, then flow into the twelve collaterals. There are not only fourteen collaterals.”

The “fourteen collaterals” refers to the collaterals of the Twelve Channels, together with the collaterals of the Conception Vessel and the Governor Vessel. The Spleen’s Great Collateral—a larger collateral of the Spleen Channel—arises from the Spleen, so it is not listed separately here.

The phrase “ten channels whose internal divisions are distributed within the body” means that the collaterals of ten channels are distributed inside the body. “Divisions” refers to the spaces between the joints; here, it means the channels and collaterals that run between the joints. Although they branch off separately, the pathogenic Qi they receive still flows back and pours into the channels of the Five Viscera. There are five on each side, so together they are called the “ten channels.”

The above is from volume 32 of Supplementary Annotations and Explanatory Text to the Plain Questions of the Yellow Emperor’s Inner Classic.