《黃帝內經素問補註釋文》Vol. 35

The Yellow Emperor asked, “Why does Lesser Yin govern the kidneys? And why do the kidneys govern water?”

Qibo replied, “The kidneys belong to the utmost Yin, and the utmost Yin is associated with abundant water. The lungs belong to Greater Yin, while Lesser Yin corresponds to the pulse pattern of winter. Thus, the kidneys are the root and the lungs the branch; both are associated with the accumulation of fluids.”

Here, “Yin” refers to cold. Winter is the coldest season, and the Qi of the kidneys corresponds to winter, so the kidneys are said to belong to the utmost Yin. Water is most abundant in winter, so the utmost Yin is associated with abundant water. The Kidney Meridian of Foot Lesser Yin rises from the kidneys, passes through the liver and diaphragm, and enters the lungs. That is why the kidneys are called the root and the lungs the branch. When the Qi of the kidneys rises counter to its normal course, water Qi remains in the lungs; thus, both the kidneys and lungs are associated with the accumulation of fluids.

The Yellow Emperor asked, “Why can the kidneys retain water and cause illness?”

Qibo replied, “The kidneys are the gateway of the stomach. When the gateway does not open freely, water accumulates and spreads along areas of a similar kind.”

“Gateway” refers to the part that governs entry and exit. The kidneys govern the lower burner, the region of the organs in the lower part of the body. The bladder is their paired bowel, and the kidneys also govern the distribution of fluids and the unobstructed flow through the two lower orifices. When the Qi of the kidneys moves normally, the two lower orifices remain open; when they are blocked, the stomach becomes distended. That is why the kidneys are called the gateway of the stomach. When the gateway is blocked, water accumulates. When water accumulates, Qi stagnates; when Qi stagnates, it generates more water. As water accumulates, Qi also becomes congested. Since Qi and water are similar in nature, a blocked gateway causes water to accumulate and spread along areas of a similar kind. The Ling Shu Jing says, “When fluids overflow in the lower burner, edema forms.” This is the principle being described. The term bi means “blocked” or “obstructed.”

When fluids overflow upward and downward into the skin, swelling forms. Swelling is an illness caused by the accumulation of fluids.

Here, “upward” refers to the lungs and “downward” to the kidneys. When fluids from both the lungs and kidneys overflow, water gathers in the abdomen and causes illness.

The Yellow Emperor asked, “Do all water disorders arise from the kidneys?”

Qibo replied, “The kidneys are a Yin organ.”

“Female” refers to Yin. The kidneys also govern the Yin position, so they are called a Yin organ.

Earth Qi rises and corresponds to the kidneys, thereby producing fluids. Thus, when the Qi of the utmost Yin becomes excessive and a person is overworked, the kidneys sweat. When kidney sweat encounters wind, it cannot enter the organs internally or pass out through the skin externally, so it remains in the pores…

Wind-water is a disorder in which wind evil enters through the body’s surface, causing fluids to collect and stagnate. When a person is strong and active but overexerts themselves, they sweat profusely, and the sweat pores, or “mysterious portals” (xuanfu), open. If wind strikes while they are sweating, the pores close again. Sweat that has not yet been released remains inside the body, lodging between the skin and flesh and transforming into fluid. Because the stagnation of fluid is associated with wind evil, the condition is called “wind-water.”

The “mysterious portals” are the sweat pores. The word “portal” (fu) in “mysterious portals” carries the sense of gathering. Sweat is dark in color and leaves the body through the pores; when it gathers and remains inside the body, this is described as a gathering within the “mysterious portals.”

The Yellow Emperor asked, “What conditions are treated by the fifty-seven acupoints for water disorders—the points used in acupuncture and moxibustion?” Qi Bo replied, “The fifty-seven acupoints of the kidneys are places where Yin Qi gathers, and channels through which fluids enter and leave.”

Above the buttocks, the back has five rows of acupoints, with five points in each row. These belong to the kidney shu points. In all, the back’s acupoints are arranged in five rows: the central row is where the Qi of the Governing Vessel emerges, while the four rows on either side are where the Qi of the Foot Taiyang channel emerges.

Thus, when a water disorder develops downward, it causes swelling and abdominal distention; when it affects the Lung above, it causes panting and shortness of breath. Fluid stagnating in the Kidneys causes swelling from below the abdomen down to the feet. Fluid rising to affect the Lung brings panting, shortness of breath, and labored breathing.

A person’s inability to lie flat occurs because both the branch and the root are diseased. The “branch” refers to the Lung, and the “root” to the Kidneys. In this condition, water disorder affects both: Lung disease causes panting, while kidney disease causes edema. When Lung Qi surges upward, the person pants and cannot lie flat. The Lung governs breathing, so Lung disease causes panting; the Kidneys govern water, so kidney disease causes edema.

Water disorders affect different parts of the body and can be associated with different acupoints. But in terms of their cause, all these areas may be affected by Qi and fluids stagnating together.

Above the Futu point, there are two rows of acupoints on each side of the abdomen, with five points in each row. These are the pathways of the kidney channel through the abdomen. “Street” means a road. Five rows of acupoints are arranged on either side of the abdominal midline: the two rows closest to the navel are where the Qi of the kidney channel and the Thoroughfare Vessel emerge; the two rows farther out are where the Qi of the Stomach channel emerges. All four rows lie above the Futu point.

The three Yin channels meet at the feet. On the upper surface of each foot is a row of six points, marking the route by which the kidney channel descends. This is called “Great Surge” (Taichong). The kidney channel and the Thoroughfare Vessel run downward together, travel along the feet, and converge there. Their Qi is abundant and vigorous, hence the name “Great Surge.”

The so-called “fifty-seven points” are all points where the network vessels that store Yin are located—that is, places where fluids collect and stagnate.

The fifty-seven points mentioned in the scripture refer to five rows above the sacrum, with five points in each row. The middle row of the back belongs to the points where the Qi of the Governor Vessel emerges. It consists of five points: Spine Center, Suspended Pivot, Gate of Life, Lumbar Transport, and Long Strength. The two rows on either side of the Governor Vessel belong to the points where the Qi of the Foot Taiyang channel emerges. Each has five points: Large Intestine Transport, Small Intestine Transport, Bladder Transport, Inner Transport of the Middle Back, and White Ring Transport. The two rows farther out also belong to the points where the Qi of the Foot Taiyang channel emerges. Each has five points: Stomach Granary, Vitals Gate, Will Chamber, Womb Vitals, and Border of Order.

Above the Futu point, there are two rows on each side, with five points in each row, making twenty points in all. The points in the middle of the abdomen lie on either side of the Conception Vessel, where it meets the Thoroughfare Vessel and the Foot Shaoyin channel. They are five in number: Central Injection, Four Fullnesses, Qi Point, Great Brightness, and Horizontal Bone. Farther out, on either side of the Thoroughfare Vessel and the Foot Shaoyin channel, are points where the Qi of the Foot Yangming channel emerges. They are five in number: Outer Mound, Great Gigantic, Waterway, Return, and Qi Street.

Above the ankles, there is one row on each side, with six points in each row. Above the medial ankle, the Foot Shaoyin channel and the Yin Heel Vessel ascend alongside each other. The Foot Shaoyin channel has three points: Great Bell, Return Flow, and Yin Valley. The Yin Heel Vessel has three points: Shining Sea, Exchange Faith, and Guest House. The Yin Heel Vessel is a collateral branch of the Foot Shaoyin channel and may also be considered under its governance. Even so, the total still falls short by one point.

The Spine Center point lies below the eleventh vertebra. Locate it with the patient bent forward. The needle may be inserted five fen, measured according to the proportions of the patient’s own body. Moxibustion should not be applied. Needling this point may cause the person to bend at the waist. The Suspended Pivot point lies below the thirteenth vertebra. Locate it with the patient bent forward; the needle may be inserted three fen. Moxibustion may be applied for three cones, each cone counting as one unit when burned through. The Gate of Life point lies below the fourteenth vertebra. Locate it with the patient bent forward; the needle may be inserted five fen. Moxibustion may be applied for three cones.

The Lumbar Transport point lies below the twenty-first vertebra. The needle may be inserted two fen. The New Corrected Edition says that the Jia Yi Jing, the Commentary on the Treatise on Needling Contrary to the Channels, and the Commentary on Heat Points all record an insertion depth of two cun; however, the Commentary on Needling Heat, the Commentary on the Qi Points, and this commentary record two fen. The two-fen reading should therefore be followed. Retain the needle for seven breaths. Moxibustion may be applied for three cones.

The Long Strength point lies at the end of the spine, where a collateral branch of the Governor Vessel joins the Foot Shaoyin channel. The needle may be inserted…

For these five points, insert the needle two fen and retain it for seven breaths; if using moxibustion, apply three cones. All five are places where the Qi of the Governing Vessel (Du Mai), which runs along the midline of the back, emerges.

The New Editorial Correction says: Wang Bing believed that one point was missing here. The annotation to “Discussion of Qi Points” records a Yangguan point below the twelfth vertebra. If Yangguan is included, the number of points is complete.

Next are the points on either side of the Governing Vessel. Dachangshu lies below the sixteenth vertebra, one and a half cun to either side of the Governing Vessel. Insert the needle to a depth of three fen and retain it for six breaths; apply three cones of moxibustion. Xiaochangshu lies on either side below the eighteenth vertebra. Its spacing, needling and moxibustion depths, and number of cones are the same as for Dachangshu. Pangguangshu lies on either side below the nineteenth vertebra, and Zhongluneishu on either side below the twentieth; their spacing and needling and moxibustion methods are also the same as for Dachangshu. To locate Zhongluneishu, find the points on either side of the spine where the back muscles bulge, and retain the needle for ten breaths. Baihuanshu lies on either side below the twenty-first vertebra, at the same distance from the spine as Dachangshu. Locate it with the patient prone. Insert the needle to a depth of five fen; apply three cones of moxibustion.

The New Editorial Correction says: According to the Jia Yi Jing, the needling depth for Baihuanshu should be eight fen, and moxibustion should not be used. These five points are all places where the Qi of the Foot Taiyang channel, the Foot Taiyang Bladder channel, emerges. The Shenshu mentioned here is also one of this group of points.

Farther out on either side is Weicang, below the twelfth vertebra, three cun from the Governing Vessel on each side. Insert the needle to a depth of five fen; apply three cones of moxibustion. Huangmen lies on either side below the thirteenth vertebra, and Zhishi on either side below the fourteenth. Their spacing and needling and moxibustion methods are the same as for Weicang. Locate Zhishi with the patient sitting upright. Baohuang lies on either side below the nineteenth vertebra; its spacing and needling and moxibustion methods are the same as for Weicang. Locate it with the patient prone. Zhibian lies on either side below the twenty-first vertebra; its spacing and needling and moxibustion methods are also the same as for Weicang. Locate it with the patient prone. All five points are places where the Qi of the Foot Taiyang channel emerges.

Next is Zhongzhu, in the second row above Futu: it lies five fen below the navel, five fen to either side of the Conception Vessel (Ren Mai), which runs along the midline of the front of the body.

The New Corrected Edition states: This agrees with the account in the Jia Yi Jing. The commentary to “Qi Fu” says, “one cun laterally from the center of the midline.” Although the wording differs, the meaning is the same.

The Siman acupoint lies one cun below Zhongzhu. Here, “cun” is measured in proportion to the body and is called a “body cun.” The Qixue acupoint lies one cun below Siman; Dahe lies one cun below Qixue; and Henggu lies one cun below Dahe. These acupoints are each one cun apart horizontally and intersect with the Chong Mai and the Foot Shaoyin channel. Needling may reach one cun deep; with moxibustion, five cones may be applied.

Next are the acupoints on the two outer sides. The Waiguan acupoint lies one cun below the navel. The New Corrected Edition states: According to the commentary to “Qi Fu Lun,” Waiguan lies one cun below Tianshu, exactly as stated here. On either side of Waiguan, the acupoints lie one and a half cun from the Chong Mai. Juju lies one cun below Waiguan; Shuidao lies three cun below Juju; Guilai lies three cun below Shuidao; and Qijie lies below Guilai.

The New Corrected Edition states: According to the commentaries to “Qi Fu,” “Ci Re,” and “Re Xue,” Qijie lies on the abdomen, one cun below the navel, at the two ends of Henggu and above the groin. The commentary to “Ci Jin” says it lies on both sides of the abdomen, four cun apart, one cun above Shupu, where a pulse can be felt under the fingers when pressed. The commentary to “Gu Kong” says it lies on both sides of the pubic hairline, above the groin. These commentaries differ, so they are all recorded here.

At one cun above the groin, there is one acupoint on each side, two cun apart horizontally. All five of these acupoints are places where the Qi and blood of the Foot Yangming channel flow and gather. Needling at Shuidao may reach two and a half cun deep; with moxibustion, five cones may be applied. At Qijie, needling may reach three fen, with the needle retained for seven breaths; with moxibustion, three cones may be applied. At the other three acupoints, needling may reach eight fen; with moxibustion, five cones may be applied at each. What is called the “Kidney Street” refers to this area.

Above each ankle, on both sides, is a row of six acupoints. The Dazhong acupoint lies in the channel pathway behind the inner ankle. The New Corrected Edition states: In the Jia Yi Jing, this is written as “in the center of the channel behind the heel”; the commentaries to “Ci Nüe” and “Ci Yao Tong” say “in the pulsating channel behind the heel.” The reference here to “behind the inner ankle” differs from other accounts, so this note may be mistaken.

The collateral channel of the Foot Shaoyin branches off here and runs toward the Foot Taiyang channel. Needling may reach two fen deep.

If a needle is retained for three breaths, moxibustion may be applied for three cones. Fuliu is located in a hollow two inches above the inner ankle. The Foot Shaoyin meridian passes through this point. The needle may be inserted three fen and retained for three breaths; moxibustion may be applied for five cones.

Zhaohai is located below the inner ankle. The needle may be inserted four fen and retained for six breaths; moxibustion may be applied for three cones.

Jiaoxin is located two inches above the inner ankle, between the bones and tendons, in front of the Foot Shaoyin meridian and behind the Foot Taiyin meridian. It is the xi-cleft point of the Yin Heel Vessel, where the qi and blood of a meridian gather and which is suited to treating acute conditions. The needle may be inserted four fen and retained for five breaths; moxibustion may be applied for three cones.

Zhubin is located above the inner ankle, where the calf muscles divide. It is the xi-cleft point of the Yin Linking Vessel. The needle may be inserted three fen; moxibustion may be applied for five cones.

Yingu is located on the inner side below the knee, behind the small bone, beneath the large tendon and above the small tendon. The point can be felt by pressing, and is easier to locate when the knee is bent. This is where the Foot Shaoyin meridian enters. The needle may be inserted four fen; moxibustion may be applied for three cones. The place where the Kidney meridian descends, called “Taichong,” refers to this point.

The Yellow Emperor asked, “Why, in spring, do we treat the area between the collaterals and the intermuscular spaces?” Qibo replied, “In spring, the Wood phase begins to govern, and Liver qi begins to arise. Liver qi moves rapidly, and Wind pathogens arrive swiftly. The meridians generally lie deep, but in spring the body’s strength is slight and cannot reach deeply. Therefore, treatment is directed to the area between the collaterals and the intermuscular spaces.”

The Yellow Emperor asked, “Why, in summer, do we treat the flourishing meridians and the intermuscular spaces?” Qibo replied, “In summer, the Fire phase begins to govern, and Heart qi begins to grow vigorous. The vessels are fine and strength is weak. Yang qi lingers and disperses, while heat steams the intermuscular spaces and reaches inward to the meridians. Therefore, treatment is directed to the flourishing meridians and the intermuscular spaces. Piercing the skin with a needle to expel the pathogenic influence shows that it has remained in a relatively shallow place.” The “flourishing meridians” mentioned here refers to the Yang meridians.

The Yellow Emperor asked, “Why, in autumn, do we treat the meridians and transport points?” Qibo replied, “In autumn, the Metal phase begins to govern, and Lung qi is about to gather and become austere. The qi of the Three Yin meridians gradually rises, and the body too gradually enters a phase of gathering. Metal is about to overcome Fire because Metal qi is growing stronger while Fire qi is waning. Yin qi begins to gain the upper hand, and Dampness also assails the body. As rain, dampness, mist, and dew become more plentiful, the body is easily affected by dampness. At this time Yin qi is not yet flourishing, and the pathogenic influence has not penetrated deeply. Therefore, the transport points are treated to disperse Yin pathogens, and the He-Sea points are also treated…”

This is because the Qi of deficient Yang and pathogenic Yang begins to decline, so the He-Sea points—where the Qi and blood of the channels converge and penetrate deeply—are selected for treatment.

The New Editorial Correction says: According to Huangfu Shi’an, this is the method of treatment “at the beginning of autumn.”

The Yellow Emperor asked: In winter, why select the Jing-Well and Ying-Spring points?

Qibo replied: In winter, Water Qi begins to govern, and Kidney Qi is stored away. Yang Qi is diminished, while the Qi of Lesser Yin is firm and flourishing; the Qi of Greater Yang lies hidden and sinks, and the Yang channels recede along with it.

“Recede” means that Yang Qi sinks downward.

Therefore, the Jing-Well points are selected to guide the counterflowing Yin Qi downward, and the Ying-Spring points are selected to replenish Yang Qi.

The New Editorial Correction says: In the edition by Quan Yuanqi, “replenish” is written as “dispel”; the Jia Yi Jing and Qian Jin Fang have “open through.”

Thus it is said that selecting the Jing-Well and Ying-Spring points in winter prevents nasal congestion and nosebleeds in spring.

The New Editorial Correction says: According to Huangfu Shi’an, this is the method of treatment “before the onset of winter.”

That is the principle being described.

The New Editorial Correction says: The meaning of this passage differs considerably from that of the “Treatise on Needling in Accord with and Contrary to the Four Seasons” and the “Treatise on the Essentials of Diagnosis and the Termination of the Channels,” but accords with the account in the Nine Scrolls—that is, the Ling Shu.

The Yellow Emperor asked: You once said that treating heat illness requires the use of fifty-nine Shu points—the points where the Qi of the channels flows to the body’s surface and can be needled. I have considered the principle behind this, but still do not fully understand where these points are located. I hope you will explain their precise positions and the reasoning behind them.

Qibo replied: On the head are five rows of points, with five points in each row, making twenty-five in all. They are used to disperse pathogenic heat rising along the various Yang channels.

In the five rows of points on the head, the central row runs in sequence from Shangxing, Xinhui, Qianding, Baihui, to Houding. The row immediately to either side runs from Wuchu, Chengguang, Tongtian, Luoque, to Yuzhen. The outermost row runs from Linqi, Muchuang, Zhengying, Chengling, to Naokong.

Shangxing is on the midline of the head, directly above the bridge of the nose, in a depression one cun inside the hairline. It may be needled to a depth of three fen. Xinhui is in a depression one cun behind Shangxing and may be needled to a depth of four fen. Qianding is in a depression between the cranial sutures, one cun and five fen behind Xinhui; it is needled in the same way as Xinhui. Baihui is one cun and five fen behind Qianding, in a depression at the central vortex on the crown of the head, large enough to fit a finger. It is where the Governing Vessel meets the Foot Greater Yang channel, and is needled in the same way as Shangxing. Houding is one cun and five fen behind Baihui, above the occipital bone, and is needled in the same way as Xinhui.

These five points are all places where the Qi of the Governing Vessel emerges. Retain the needle at Shangxing for the time it takes to breathe six times; alternatively, apply five moxa cones. Among the points on either side, Wuchu is located on both sides of Shangxing...

The locations of the head points are measured in “body inches,” a unit of length calculated according to the proportions of the patient’s own body. Chengguang lies one cun and five fen behind Wuchu; Tongtian lies one cun behind Chengguang; Luoque lies one cun and five fen behind Tongtian; and Yuzhen lies seven fen behind Luoque. All five points are places where the qi and blood of the Foot Taiyang channel are conveyed. Needling may reach a depth of three fen. Retain the needles for seven breaths at Wuchu and Tongtian, five breaths at Luoque, and three breaths at Yuzhen. If moxibustion is used, apply three cones at each point, with one cone burned counted as one application. The New Collation says that, according to the Jia Yi Jing, Chengguang should not be cauterized with moxa, and needling at Yuzhen should reach a depth of two fen.

Linqi is on the head, directly above the eye, five fen inside the hairline. It is where the Foot Taiyang and Foot Shaoyang channels and the Yangwei vessel intersect. Muchuang and Zhengying lie one cun apart in succession; Chengling and Naokong lie one cun and five fen apart in succession. Of these five points, Naokong is where the Foot Shaoyang channel and the Yangwei vessel intersect. Needling may reach a depth of four fen there, and three fen at each of the other points. Retain the needle at Linqi for seven breaths. If moxibustion is used, apply five cones.

The eight points Dazhu, Yingshu, Quepen, and Beishu, among others, can all be used to drain heat pathogens from the chest.

Dazhu is beside the first vertebra below the nape of the neck, with one point on each side, one cun and five fen from the Governing Vessel, in a hollow. It is where the collateral of the Governing Vessel and the qi and blood of the Hand Taiyang and Foot Taiyang channels intersect. Needling may reach a depth of three fen; retain the needle for seven breaths. If moxibustion is used, apply five cones. The New Collation says that, according to the Jia Yi Jing and the Commentary on the Acupoints, seven cones should be applied; the Commentaries on Needling for Malaria and Needling for Heat record five cones.

Yingshu is a chest point, formally named Zhongfu. It lies six cun to the side of the midline of the chest, one cun below Yunmen, in the third intercostal space above the breast, in a hollow where a pulse can be felt. The patient should lie on their back when locating it. It is where the qi and blood of the Hand Taiyin channel intersect. Needling may reach a depth of three fen; retain the needle for five breaths. If moxibustion is used, apply five cones.

Quepen lies in the hollow of the horizontal bone above the shoulder. It is where the qi and blood of the Hand Yangming channel emerge. Needling may reach a depth of two fen; retain the needle for seven breaths. If moxibustion is used, apply three cones.

Beishu, that is… The original text ends here.

Fengmen (Wind Gate), a point used to dispel wind and treat heat, lies below the spinous process of the second thoracic vertebra, one and a half body-inches to either side of the spine. It is where the Governor Vessel and the Foot Taiyang Bladder Channel intersect. The needle is inserted to a depth of five fen, measured in body-inches, and retained for seven exhalations. The point may also be treated with five cones of moxa.

Although the current Illustrated Canon of Acupoints in the Central Proclamations does not record this point under the name “Fengmen,” calling it “Wind Gate” and “Heat Residence” makes clear that it is a back transport point used to treat heat disorders.

The Corrected Edition says: In his commentary on “Treatise on Needling Heat” in the Plain Questions, Wang Bing writes that the precise locations of the back transport points are not clear; here, however, they are explicitly identified as Fengmen and “Heat Residence.” In his commentary on “Treatise on Qi Points,” he also identifies Dazhu as a back transport point. The three accounts differ, suggesting that Wang Bing himself was uncertain.

The eight points Qijie, Sanli, Julixialian, and Julixialian’s counterpart Julixialian’s upper and lower points can be used to drain pathogenic heat from the Stomach.

Qijie lies on the abdomen below the navel, near the two ends of the pubic bone, above the inguinal region, one body-inch from the midline. An arterial pulse can be felt there; it is where the Qi of the Foot Yangming Stomach Channel emerges. The needle is inserted to a depth of three fen, measured in body-inches, and retained for seven exhalations. The point may also be treated with three cones of moxa.

The Corrected Edition says: Commentaries differ on the location of Qijie; see the earlier note on the Water point for details.

Sanli lies three inches below the knee, between the two muscle bands on the outer side of the tibia. It is where the Qi of the Foot Yangming Stomach Channel converges. The needle is inserted to a depth of one body-inch and retained for seven exhalations. The point may also be treated with three cones of moxa.

Julixialian belongs to the intersection of the Foot Yangming Stomach Channel and the Foot Taiyang Bladder Channel. It lies three inches below Sanli and is where the Qi of the Foot Yangming Stomach Channel emerges. The needle is inserted to a depth of eight fen. The point may also be treated with three cones of moxa.

Julixialian’s lower point belongs to the intersection of the Foot Yangming Stomach Channel and the Foot Shaoyang Gallbladder Channel. It lies three inches below the upper point and is where the Qi of the Foot Yangming Stomach Channel emerges. The needle is inserted to a depth of three fen. The point may also be treated with three cones of moxa.

The eight points Yunmen, Jianyu, Weizhong, and Suikong can be used to drain pathogenic heat from the limbs.

Yunmen lies below Jugu (near the outer end of the clavicle), six inches to either side of the midline of the chest. An arterial pulse can be felt beneath the point; it is where the Qi of the Hand Taiyin Lung Channel emerges. The Corrected Edition says that both the “Qi Points” and “Treatise on Needling Heat” commentaries in the Classic of Acupuncture and Moxibustion read “Hand Taiyin.” Raise the arm to locate the point. The needle is inserted to a depth of seven fen, measured in body-inches. The point may also be treated with five cones of moxa.

The Jing of Acupoint Illustrations does not list an “Yu Bone” point. It does list the Jianyu point, located between the two bones at the tip of the shoulder, where the Hand Yangming channel meets the Qiao vessel. Needling may penetrate six body-proportional cun and the needle may be retained for six breaths. Alternatively, three moxa cones may be applied.

The Weizhong point lies in the middle of the bend behind the knee, at the center of the popliteal fossa, approximately where the artery pulses beneath the transverse crease. It is where the Qi of the Foot Taiyang channel enters. Needling may penetrate five body-proportional cun and the needle may be retained for seven breaths. Alternatively, three moxa cones may be applied.

The current Jing of Acupoint Illustrations records that the Yaoshu point, also called Sui Kong, lies below the twenty-first vertebral segment. It can be used to treat symptoms such as impaired sweating and cold, numb feet, and is where the Qi of the Governing Vessel emerges. Needling may penetrate two body-proportional cun and the needle may be retained for seven breaths. Alternatively, three moxa cones may be applied. The New Collation says that the stated needling depth of two cun at Yaoshu should read two fen; this was already explained in the note on the “Water Point” above.

The five points beside the back-shu points of the five zang organs, ten points in all, can be used to drain heat from the five zang organs. These are Pohu, Shentang, Hunmen, Yishe, and Zhishi. They lie in pairs on either side of the spine, with a distance of three body-proportional cun between the left and right points. All are places where the Qi of the Foot Taiyang channel emerges.

Pohu lies on both sides below the third vertebra. Locate it with the patient sitting upright. Needling may penetrate five body-proportional cun; alternatively, five moxa cones may be applied. Shentang lies on both sides below the fifth vertebra. Needling may penetrate three body-proportional cun; alternatively, five moxa cones may be applied. Hunmen lies on both sides below the ninth vertebra. Locate it with the patient sitting upright. Needling may penetrate five body-proportional cun; alternatively, three moxa cones may be applied. Yishe lies on both sides below the eleventh vertebra. Locate it with the patient sitting upright. Needling may penetrate five body-proportional cun; alternatively, three moxa cones may be applied. Zhishi lies on both sides below the fourteenth vertebra. Locate it with the patient sitting upright. Needling may penetrate five body-proportional cun; alternatively, three moxa cones may be applied.

These points, together known as the Fifty-Nine Points, are distributed on both sides of the body and are used to treat heat disorders.

The Yellow Emperor asked, “When a person is invaded by cold pathogen and later develops a heat disorder, why does this happen?”

Qibo replied, “When cold pathogen reaches its extreme, it produces heat. Cold Qi becomes lodged at the body’s surface, and Yang Qi then accumulates within. The skin’s interstices tighten, and the pores close. When the interstices are tight, Qi cannot spread and flow freely; when the pores are closed, dampness gathers within the body. The Qi within and at the body’s surface struggle against each other…”

Note: A body-proportional cun is a unit of length used to locate points according to the patient’s own body proportions. A zhuang is a unit for measuring moxibustion. The final sentence of the classical text is incomplete; the translation ends where the surviving text ends.

When cold pathogen (a cold influence that invades the body) is strong, heat arises within. Thus, after being exposed to cold, a person’s illness may develop into a heat pattern. If treatment with the method of inducing sweating brings recovery, this shows how an external cold pathogen can become lodged and stagnant, while the resulting internal congestion gives rise to heat. This describes a recent illness that has lasted only a few days.

“Zhichi,” pronounced with the fanqie spelling “er qie.”