《黃帝素問靈樞集註》Vol. 10

These two chapters from The Yellow Emperor's Inner Classic: Spiritual Pivot Annotations primarily discuss treatment principles for diseases and specific acupuncture therapies for various conditions.

Regarding treatment principles: If a disorder arises first followed by Qi and blood (Qi-Xue) disharmony, the primary illness should be treated first. Conversely, if Qi-blood disharmony precedes the disease, regulating Qi and blood takes priority. Conditions where heat syndromes or diarrhea trigger other symptoms also require addressing the root cause first. However, acute symptoms like abdominal distension or urinary retention demand immediate attention to the "branch" (symptoms, Biao). Practitioners must assess severity—mild cases allow simultaneous treatment of root and branch, while severe cases require focusing on the primary contradiction.

Specific treatment methods: For spinal pain radiating to the head with blurred vision, bleed the Weizhong point (BL-40) on the Foot Taiyang Bladder Channel. Chest fullness with facial swelling and speech difficulty requires points on the Foot Yangming Stomach Channel. Throat obstruction with cold extremities and constipation calls for Foot Shaoyin Kidney Channel points. Abdominal coldness with dysuria needs Foot Taiyin Spleen Channel points. Dry mouth with glue-like sensation requires Foot Shaoyin Channel points. Knee pain is treated with round-sharp needles at Dubi (ST-35). Mute patients with throat swelling use Foot Yangming points; those retaining speech use Hand Yangming points. For malaria—non-thirsty alternate-day cases use Foot Yangming; daily cases with thirst use Hand Yangming. Toothache patients unbothered by cold drinks use Foot Yangming; those averse to cold use Hand Yangming. Painless deafness uses Foot Shaoyang points; painful deafness uses Hand Yangming. Persistent nosebleeds require Foot Taiyang points, with severe cases bleeding Weizhong (BL-40). The text incompletely describes lumbar pain treatments.

(Note: "Selecting a channel" refers to choosing specific acupuncture points along the designated meridian. "Branch" (Biao) and "root" (Ben) are Chinese medical terms—Biao denotes symptomatic manifestations, Ben indicates underlying causes.)

This passage primarily discusses acupuncture point selection methods in Traditional Chinese Medicine for treating various conditions. In modern terms:

For cold sensations in the upper body, needle points along the Bladder Meridian of Foot-Taiyang and Stomach Meridian of Foot-Yangming. For heat in the upper body, select points on the Liver Meridian of Foot-Jueyin. For inability to bend forward or lift the head, use the Gallbladder Meridian of Foot-Shaoyang. For fever with panting, choose the Kidney Meridian of Foot-Shaoyang and perform bloodletting at the prominent blood vessels behind the knees.

For emotional fluctuations with loss of appetite and increasingly sparse speech, gently needle the Spleen Meridian of Foot-Taiyin. For frequent anger with excessive talking, needle the Gallbladder Meridian of Foot-Shaoyang. For chin pain, needle the Large Intestine Meridian of Hand-Yangming and perform bloodletting at visible chin vessels. For neck pain preventing looking up or down, needle the Bladder Meridian of Foot-Taiyang; for inability to turn the head, needle the Small Intestine Meridian of Hand-Taiyang.

For lower abdominal distension extending upward to the stomach and heart regions, with alternating chills and fever plus difficult urination, select the Liver Meridian of Foot-Jueyin. For abdominal fullness with constipation, when distension rises to chest and throat causing panting, use the Kidney Meridian of Foot-Shaoyang. For abdominal distension, indigestion with obvious bowel sounds but constipation, choose the Spleen Meridian of Foot-Taiyin.

For heart pain radiating to the lumbar spine with nausea, needle the Kidney Meridian of Foot-Shaoyang. For heart pain with abdominal distension and constipation, needle the Spleen Meridian of Foot-Taiyin. For heart pain extending to the back with breathing difficulty, first needle the Kidney Meridian of Foot-Shaoyang; if ineffective, then use the Triple Burner Meridian of Hand-Shaoyang. For heart pain radiating to the lower abdomen with shifting fullness and difficulty with bowel movements, needle the Liver Meridian of Foot-Jueyin.

For simple heart pain with shortness of breath, needle the Lung Meridian of Hand-Taiyin. For heart pain near the ninth thoracic vertebra, apply pressure before needling—relief should be immediate; if ineffective, search for tender spots above and below before needling. For chin pain, needle the mandibular artery along the Stomach Meridian of Foot-Yangming, stopping at blood appearance; if ineffective, applying pressure at Renying point (carotid artery area) may help.

For upward rushing qi, needle the sternal notch and subclavian artery below. For abdominal pain, needle the arteries on both sides of the navel, pressing after needling for effect; if ineffective, needle Qichong point (femoral artery area). For weak, cold limbs, quickly release limb bindings twice daily—numbness should improve within ten days, stopping when cured. For hiccups, stimulate nostrils with grass to induce sneezing; for breathing difficulty, quickly guide qi circulation; sudden fright can also stop hiccups.

Note: The term "wandering bi" (周痹) refers to migratory pain. The Yellow Emperor asked Qibo whether this pain travels through blood vessels or between muscles, and why it moves so quickly that needling becomes difficult.

Huangdi (the Yellow Emperor) asked Qibo: "When a patient's pain ceases after treatment, what principle governs this?" Qibo replied: "This is 'wandering bi' (a localized migratory arthralgia), not 'systemic bi' (whole-body arthralgia)." Huangdi expressed his desire to understand the characteristics of wandering bi.

Qibo explained: "The hallmark of wandering bi is that the pain shifts between different body parts intermittently, appearing alternately on corresponding left and right areas without spreading throughout the entire body." When Huangdi inquired about acupuncture treatment, Qibo advised that even when pain temporarily stops, the original affected area should still be needled to prevent recurrence.

Huangdi then asked about systemic bi. Qibo clarified that systemic bi occurs when pathogenic factors flow up and down along blood vessels without lateral shifting. The treatment method is: for pain moving downward, first needle the lower region to block the pathogen before treating the upper area to relieve symptoms; for upward-moving pain, treat the upper region first.

Regarding etiology, Qibo explained that wind, cold, and dampness invade muscle interstices, causing body fluids to congeal into froth. When encountering cold, this accumulates and compresses muscles, creating pain. During pain episodes, concentrated qi and blood generate heat sensations—when the heat dissipates and pain stops, the condition relocates elsewhere.

Huangdi comprehended: "This illness resides neither in internal organs nor on the body surface, but lingers between muscles, preventing true qi (vital energy) from circulating freely—hence called systemic bi." For treatment, he noted one must first examine deficiency/excess in the six meridians (the three yin and three yang channels of hands and feet), observe whether major collaterals show blood stasis, apply warm compresses for dredging, and guide qi-blood flow for muscular spasms.

In the supplementary "Oral Inquiry" section, Huangdi privately consulted Qibo: "Having studied the nine-needle theory and six-meridian yin-yang principles, I wish to learn secret teachings transmitted orally." Qibo respectfully acknowledged this as an excellent question, describing these as precious teachings passed down verbally from master to disciple.

(Note: The "warm compresses" refer to traditional herbal heat therapy; "muscular spasms" indicate convulsive rigidity; "six meridians" denote the triple yin-yang channel system of hands and feet.)

The Yellow Emperor inquired of Qibo about the causes of disease. Qibo replied: All illnesses initially arise from external factors like wind, rain, cold, and summer heat; internal imbalances of Yin and Yang; emotional extremes of joy and anger; improper diet; and irregular daily routines. When a person experiences sudden fright or fear, it causes the separation of Qi and blood, imbalance of Yin-Yang, obstruction of meridians, and blockage of pulse pathways. When the movement of Yin and Yang energies becomes disordered, defensive Qi (the body's protective energy) stagnates, the meridians become empty, and the circulation of Qi and blood becomes abnormal—this leads to the loss of one's normal physiological state. Since these pathological changes are not thoroughly documented in medical classics, allow me to explain their underlying principles.

The Emperor asked what kind of Qi causes yawning. Qibo explained: Defensive Qi circulates in the Yang aspect (the body's exterior) during the day and in the Yin aspect (the interior) at night. Yin governs the night and descends, while Yang governs the day and ascends. When Yin accumulates below at night while Yang has not yet fully receded, the two energies pull against each other—Yang drawing upward and Yin pulling downward—resulting in frequent yawning. When Yang fully recedes and Yin dominates, one closes their eyes to sleep; when Yin recedes and Yang flourishes, one awakens. The treatment involves draining the Kidney Meridian of Foot-Shaoyin and supplementing the Bladder Meridian of Foot-Taiyang.

The Emperor asked about the Qi responsible for hiccups. Qibo said: After food enters the stomach, stomach Qi should naturally ascend to the lungs. If cold lingers in the stomach and clashes with newly ingested food Qi, upright Qi and pathogenic Qi struggle against each other, causing stomach Qi to rebel upward, forming hiccups. Treatment requires supplementing the Lung Meridian of Hand-Taiyin and draining the Kidney Meridian of Foot-Shaoyin.

The Emperor inquired about the cause of sobbing. Qibo explained: This occurs when Yin is excessive and Yang is deficient, Yin moves swiftly while Yang moves slowly, and Yin reaches its peak while Yang declines. Treatment involves supplementing the Bladder Meridian of Foot-Taiyang and draining the Kidney Meridian of Foot-Shaoyin.

The Emperor asked about the reason for chills and shivering. Qibo said: When cold invades the skin, Yin dominates while Yang is deficient, leading to trembling and aversion to cold. Treatment requires supplementing all the Yang meridians.

The Emperor questioned the cause of belching. Qibo explained: Cold lingers in the stomach, and rebellious Qi disperses upward from below, emerging from the stomach as belching. Treatment involves supplementing the Spleen Meridian of Foot-Taiyin and the Stomach Meridian of Foot-Yangming. Some also suggest supplementing the acupoint between the eyebrows.

The Emperor asked about sneezing. Qibo said: When Yang Qi harmonizes and fills the chest, it rushes out through the nostrils, causing sneezing. Treatment involves supplementing the Ying-Spring point of the Bladder Meridian of Foot-Taiyang and the area between the eyebrows. Some also recommend supplementing the point above the eyebrows.

The Emperor inquired about the cause of bodily weakness and limpness. Qibo explained: When stomach Qi is deficient and unable to nourish fully, all meridians become empty; empty meridians lead to slackened sinews and weakness...

This passage primarily discusses the relationship between various abnormal symptoms in the human body and the state of internal organs, Qi, and blood, along with corresponding regulation methods.

When a person becomes lethargic and lazy, the Qi and blood flow in the Yin meridians becomes obstructed, leading to muscular weakness that's difficult to recover from. In such cases, nourishing treatment should be applied between the muscles of affected areas. The Yellow Emperor asked why people shed tears when grieving. Qibo explained: The heart governs all five solid and six hollow organs, while the eyes serve as convergence points for numerous meridians and pathways for bodily fluids to ascend. The mouth and nose are gateways for breath. When grief and sorrow affect a person, the heart is stirred, subsequently impacting all organs, causing meridians to respond and fluid pathways to open—hence tears and nasal discharge flow. These fluids nourish Jing (essence) and moisten the orifices. Continuous weeping depletes these fluids, preventing Jing from nourishing the eyes, eventually leading to vision loss—a condition called "depletion of essence." The treatment involves supplementing the Tianzhu meridian (located on both sides of the neck).

The Yellow Emperor inquired why people sigh. Qibo replied: Worry and overthinking tense the heart system, causing Qi pathways to constrict and malfunction, hence sighing serves to stretch them. The treatment involves supplementing the Hand Shaoyin Heart meridian and Foot Shaoyang meridian.

Regarding drooling, Qibo explained: After food enters the stomach, heat in the stomach agitates parasites, relaxing the stomach and opening the Lianquan point (an acupoint in the oral cavity), resulting in salivation. The treatment involves supplementing the Foot Shaoyin meridian.

Tinnitus occurs because ears are also meridian convergence points. An empty stomach weakens the meridians, and insufficient descending Qi and blood flow causes ringing. The treatment involves supplementing the Kezhuren point (in front of the ear) and the junction between fingernail and flesh on the thumb.

Involuntary tongue-biting results from rebellious Qi and blood surging upward. Different meridian Qi rebellions cause biting in different areas: Shaoyin meridian Qi rebellion causes tongue-biting, Shaoyang causes cheek-biting, and Yangming causes lip-biting. The corresponding meridians should be supplemented based on specific symptoms.

All these abnormal symptoms occur when pathogenic Qi invades the orifices. Wherever pathogenic Qi resides, it indicates insufficient Zheng Qi (upright Qi). Specific manifestations include: insufficient Qi in the upper burner (heart/lungs) causes dizziness and tinnitus; insufficient Qi in the middle burner (spleen/stomach) leads to abnormal urination/defecation and intestinal rumbling; insufficient Qi in the lower burner (liver/kidneys) results in weak limbs and chest oppression. The treatment always involves supplementing the corresponding foot meridians.

The Yellow Emperor asked Qibo: "How should these ailments be treated?" Qibo replied:

Frequent yawning indicates insufficiency of kidney Qi (Shenqi) and requires tonifying points along the Foot-Shaoyin Kidney Meridian. Hiccups result from disharmony in lung Qi (Feiqi) and should be treated by needling points on both the Hand-Taiyin Lung Meridian and Foot-Shaoyin Kidney Meridian. Sobbing occurs when Yin-Yang energies become disconnected - in such cases, tonify the Foot-Taiyang Bladder Meridian while reducing the Foot-Shaoyin Kidney Meridian. For chills and shivering, apply tonification to points along all Yang meridians.

Belching requires tonifying both the Foot-Taiyin Spleen Meridian and Foot-Yangming Stomach Meridian. Sneezing calls for tonification of the Foot-Taiyang Bladder Meridian. For drooping eyebrows ("meiben duo"), select points between the affected muscles for tonification based on the specific location. Uncontrollable tearing should be treated by tonifying Tianzhu point (located at the nape). Frequent sighing necessitates tonifying the Hand-Shaoyin Heart Meridian, Pericardium Meridian, and points along the Foot-Shaoyang Gallbladder Meridian.

Excessive salivation requires tonifying the Foot-Shaoyin Kidney Meridian, while tinnitus calls for tonification of the Kezhuren point (anterior to the ear). For tongue-biting symptoms, select points for tonification according to the affected meridian. Dizziness and head tilting should be treated by tonifying points below the external ankle. For limp limbs and chest distress, needle points two cun above the web between the big toe and second toe, or alternatively select points below the external ankle.

(Note: The terms "tonify" (bu) and "reduce" (xie) refer to acupuncture techniques - tonification strengthens meridian Qi and blood, while reduction clears stagnation. "Liu zhi" refers to needle retention, keeping the needle inserted for a period after insertion.)