《黃帝素問靈樞集註》Vol. 8

The Yellow Emperor inquired of his minister Bo Gao: "When we speak of the lengths of the meridians, how are these standards determined?" Bo Gao replied that first one must measure the size, width, and length of each joint in the human skeletal structure, and thus the standard lengths of the meridians can be established.

The Emperor then asked: "For an average person seven and a half chi tall, what are the specific measurements of their entire skeletal structure?" Bo Gao explained in detail:

The largest circumference of the head measures two chi six cun; the chest circumference four chi five cun; the waist circumference four chi two cun. From the hairline to the nape is one chi two cun; from the chin to the hairline one chi. From the Adam's apple to the center of the collarbone (Quepen point) is four cun; from the collarbone to the lower end of the sternum (Xiongyu) nine cun—if this distance is overly long it indicates large lungs, if short indicates small lungs. From the lower sternum to the navel (Tianshu point) eight cun—overly long indicates a large stomach, short indicates small. From the navel to the pubic bone (Henggu) six and a half cun—overly long indicates wide and lengthy large intestines, short indicates narrow and short.

The lower limb measurements are equally meticulous: From the upper edge of the pubic bone to the upper inner knee measures one chi eight cun; between the upper and lower edges of the inner knee three and a half cun; from the lower knee to the inner ankle one chi three cun; inner ankle to ground three cun. From behind the knee to the instep connection one chi six cun; instep to ground three cun. Those with thick bones will exceed these standards, while slender individuals will fall short.

Other crucial measurements include: From the mandibular angle to the collarbone (Zhugu) one chi; the hidden part of the armpit four cun; from underarm to rib end one chi two cun; ribs to hip joint (Bishu) six cun; hip joint to knee one chi nine cun; knee to outer ankle one chi six cun; outer ankle to the lateral foot protrusion (Jinggu) three cun; Jinggu to ground one cun.

Head width measurements: Between the mastoid processes (Wangu) nine cun; between the ear fronts (Ermen points) one chi three cun; between cheekbones seven cun. Chest measurements: Between nipples nine and a half cun; between hip joints six and a half cun. Foot length one chi two cun; width four and a half cun. For upper limbs: Shoulder to elbow one chi seven cun; elbow to wrist one chi two cun.

These precise skeletal measurements provided ancient physicians with essential references for determining organ sizes and meridian pathways. By comparing against these standard dimensions, abnormalities in the zang-fu organs could be diagnosed.

From the wrist to the base of the middle finger measures four cun (an ancient Chinese unit), while from the base to the fingertip is four and a half cun. The distance from the hairline at the nape to the topmost vertebra is two and a half cun, and from there down to the coccyx there are twenty-one vertebrae totaling three chi in length. The upper vertebrae each measure approximately one cun, four fen, and one li (ancient measurement units), while the lower vertebrae vary in length. From the seventh vertebra to the pelvis spans nine cun, eight fen, and seven li. These are standard skeletal measurements used to determine meridian lengths.

When examining the body's meridians, those that appear superficial and feel firm to the touch, or are noticeably thick, indicate abundant Qi and blood. Thin, deep-set meridians suggest stronger Qi movement.

The Yellow Emperor inquired of Qibo about the relationship between human Qi-blood circulation and celestial movements. Qibo explained: The celestial sphere contains twenty-eight lunar mansions (ancient astronomical constellations), each occupying thirty-six fen divisions. One complete cycle of human Qi-blood circulation corresponds to 1,080 fen divisions of celestial movement (28 mansions × 36 fen). The sun's daily path crosses these twenty-eight mansions, just as twenty-eight major meridians traverse the human body, totaling sixteen zhang and two chi in length, mirroring the celestial pattern. Ancient timekeeping used water clocks with one hundred ke (marks) to divide day and night.

With each breath, the pulse beats twice while Qi-blood advances three cun; one complete inhalation-exhalation cycle moves it six cun. Ten breaths move Qi-blood six chi, equivalent to two fen of celestial movement. After 270 breaths completing one full-body circulation, two ke of water drip from the clock as the sun advances twenty-five fen. Five hundred forty breaths complete two cycles with four ke dripped. Continuing this pattern, when 13,500 breaths (fifty cycles) complete, one hundred ke have dripped—marking one full day-night cycle as the sun completes its journey through all twenty-eight mansions. This synchronous movement between Qi-blood and celestial bodies embodies the concept of "cosmic correspondence." Completing fifty full cycles achieves the lifespan endowed by heaven and earth, with Qi-blood having traversed eight hundred ten zhang in total.

Regarding the movement of nutritive Qi (Ying Qi, the refined essence nourishing the body): Food and drink form its foundation. After entering the stomach, the refined essence ascends to the lungs, partially circulating internally while another portion spreads to the body's surface. The purest essence follows the pathways of the meridians.

This scripture elucidates the patterns of Qi-blood circulation within the human body and the measured lengths of the meridians.

It first describes the circulatory pathway of Nutritive Qi (the refined substance that nourishes the internal organs): originating from the Taiyin Meridian (Hand Taiyin Lung Channel), it sequentially flows through the Hand Yangming Channel, Foot Yangming Channel, and returns to the Foot Taiyin Channel, forming a complete cycle. This circulation permeates the entire body—from fingers to toes, from internal organs to the body surface—ultimately returning to its starting point, mirroring the cyclical patterns of heaven and earth's movement.

The text then details specific measurements of each meridian:

• The six Hand Yang channels measure 5 chi 5 cun from hands to head, totaling 3 zhang when combined
• The six Hand Yin channels measure 3 chi 5 cun from hands to chest, totaling 1 zhang 8 chi when combined
• The six Foot Yang channels measure 8 chi from feet to head, totaling 4 zhang 8 chi when combined
• The six Foot Yin channels measure 6 chi 5 cun from feet to chest, totaling 3 zhang 9 chi when combined
• The two Qiao vessels (Yin Qiao and Yang Qiao) measure 7 chi 5 cun from feet to eyes, totaling 1 zhang 5 chi when combined
• The Governing Vessel (Du Mai) and Conception Vessel (Ren Mai) each measure 4 chi 5 cun, totaling 9 chi when combined

The cumulative length of all meridians amounts to 16 zhang 2 chi. These measurements represent ancient physicians' quantitative understanding of the human meridian system, serving as guidance for acupuncture therapy and Qi-blood regulation.

This passage explains the fundamental principles of the human meridian system. The main channels are like highways, while their transverse branches are called connecting vessels, and the finest subdivisions are termed minute vessels. When Qi (vital energy) and blood are excessive, draining methods should be used in treatment; when deficient, they should be supplemented with medicinal tonics.

The essence (Jing) of the five zang organs connects with the external world through the seven orifices: Lung Qi connects with the nose—when lung function is normal, one can distinguish odors; Heart Qi connects with the tongue—when heart function is normal, one can discern flavors; Liver Qi connects with the eyes—when liver function is normal, one can distinguish colors; Spleen Qi connects with the mouth—when spleen function is normal, one can perceive food's taste; Kidney Qi connects with the ears—when kidney function is normal, one can hear clearly. If the five zang organs become imbalanced, the seven orifices will malfunction; if the six fu organs become disordered, Qi and blood will stagnate and form abscesses.

When pathogenic Qi resides in the six fu organs, the yang meridians' circulation becomes obstructed, causing yang energy to become excessive. This excessive yang then affects the yin meridians, causing yin blood to stagnate and yin energy to become excessive. Extreme yin excess in turn obstructs yang circulation. This state of yin-yang imbalance is called "blockage-rejection" (guange), which prevents one from living out their natural lifespan.

The Yellow Emperor asked about the origin, pathway, and function of the Motility Vessel (one of the Eight Extraordinary Meridians). Qibo replied: The Motility Vessel branches from the Lesser Yin meridian, originating behind the heel. It ascends along the inner leg, passes through the genital region and chest, emerges at the supraclavicular fossa, runs beside the Adam's apple, and finally connects to the inner canthus of the eye. The Qi of the Motility Vessel nourishes the eyes—if Qi and blood are insufficient, it can cause inability to close the eyes.

The Yellow Emperor asked why Qi circulates only through the five zang organs without nourishing the six fu organs. Qibo explained: The movement of Qi and blood is ceaseless, like flowing water and the perpetual motion of sun and moon. The yin meridians nourish the five zang organs, while the yang meridians nourish the six fu organs, cycling endlessly without termination. These circulating energies internally nourish the organs and externally moisten the skin and muscles.

The Yellow Emperor inquired about distinguishing yin and yang Motility Vessels—which serves as the standard. Qibo answered: In men, the yang Motility Vessel is the primary channel, while in women, the yin Motility Vessel is primary. The complementary vessel in each case serves as the connecting vessel.

The Yellow Emperor inquired of Qibo: From where does a person's vital essence (Jing) originate? How do the two energies of Yin and Yang interact? What is nutritive Qi (Yingqi)? What is defensive Qi (Weiqi)? How are these Qi of nourishment and defense generated? Where do they converge? Why do the elderly and the young differ in their Qi-blood circulation? What distinguishes the positions of Yin and Yang energies?

Qibo replied: Human essence derives from food and drink. When nourishment enters the stomach, its refined substances ascend to the lungs, thereby nourishing all five viscera and six bowels. The purest portion forms nutritive Qi (Yingqi, the nourishing energy), while the turbid portion becomes defensive Qi (Weiqi, the protective energy). Nutritive Qi circulates within the blood vessels, while defensive Qi patrols outside them. The nutritive Qi flows endlessly, completing fifty daily cycles before converging with defensive Qi in grand union. Yin and Yang energies interpenetrate in ceaseless circulation.

Defensive Qi moves through the Yin phase for twenty-five nightly cycles and through the Yang phase for twenty-five daily cycles, creating the alternation of day and night. When defensive Qi reaches the Yang phase, one awakens; when it enters the Yin phase, one sleeps. At midday when Yang energy peaks, it's called "double Yang" (Chongyang); at midnight when Yin energy culminates, it's termed "double Yin" (Chongyin). The Taiyin channel governs the interior, the Taiyang channel governs the exterior, each completing twenty-five cycles to demarcate day and night.

The precise rhythm operates thus: At midnight Yin energy peaks, then gradually declines; by dawn Yin exhausts itself as Yang begins ascending. At noon Yang culminates, then wanes toward dusk; sunset exhausts Yang as Yin regenerates. During midnight's convergence of nutritive and defensive Qi—when all sleep—we call this "Yin union" (Heyin). At dawn when Yin exhausts itself and Yang regenerates, this perpetual cycle mirrors heaven and earth's revolutions.

The Emperor asked: Why do elders struggle with nighttime wakefulness while youths resist daytime drowsiness? Qibo explained: The young possess vigorous Qi-blood, moistened muscles, and unobstructed energy pathways, allowing proper nutritive-defensive circulation—thus alert by day, restful by night. The elderly suffer weakened Qi-blood, withered muscles, stagnant pathways, and disharmonious visceral energies, leaving nutritive Qi deficient while defensive Qi internally agitates—resulting in daytime lethargy and nighttime insomnia.

Probing further about Qi circulation routes, Qibo clarified: Nutritive Qi originates from the middle burner (spleen-stomach region), defensive Qi from the lower burner (kidney-bladder region). Upper burner (heart-lung region) Qi emerges above the stomach's entrance, ascends along the esophagus past the diaphragm, disperses through the chest, follows the Taiyin channel via armpits, returns through the Yangming channel, and reaches beneath the tongue. The foot Yangming channel typically accompanies nutritive Qi through twenty-five Yang-phase cycles.

(Note: The "burners" refer to Sanjiao—the triple energizer—a unique TCM concept dividing the torso into upper/middle/lower functional regions; "Ying-Wei" represents fundamental TCM theory's two vital life energies governing nourishment transport and defensive functions respectively.)

The defensive Qi (Wei Qi) in the human body circulates twenty-five times through the yin meridians to complete one cycle, totaling fifty circuits before restarting, ultimately converging at the Hand Taiyin Lung Meridian.

The Yellow Emperor asked: When people consume hot food, why does sweating occur even before digestion begins? This sweat sometimes emerges from the face, sometimes from the back, or the sides of the body—deviating from the regular pathways of Wei Qi circulation. Why is this? Qibo replied: This happens due to external invasion by wind pathogens, which causes the body's pores to open. The heat energy evaporates outward through these pores, pulling the Wei Qi along in dispersion, disrupting its normal circulation. This Qi movement is swift and slippery; encountering open pores, it leaks outward—hence the term "leakage dissipation" (Lou Xie).

The Yellow Emperor asked: What is the function of the Middle Burner (Zhongjiao, the central visceral system)? Qibo said: The Middle Burner connects to the stomach and lies posterior to the Upper Burner. It separates the dregs from food, steams body fluids, and transports refined nutrients upward to the lung vessels, where they transform into blood to nourish the entire body. This is the most precious substance in the human body, circulating exclusively within the meridians—known as "Nutritive Qi" (Ying Qi).

The Yellow Emperor asked: Blood and Qi have different names but belong to the same category—how should this be understood? Qibo explained: Both Nutritive Qi and Defensive Qi are transformations of essence (Jing), while blood is a transformation of spirit (Shen). Though named differently, they share the same fundamental nature. Thus, those who have lost blood must not be induced to sweat, and excessive sweating damages blood. Losing either blood or sweat can be fatal; no one survives losing both simultaneously.

The Yellow Emperor asked: What of the Lower Burner's (Xiajiao, the lower visceral system) function? Qibo replied: The Lower Burner separates fluids from the ileum, allowing them to permeate into the bladder. Food residues form feces in the large intestine, while fluids are filtered through the Lower Burner, separating clear from turbid before permeating the bladder.

The Yellow Emperor asked: Why does alcohol cause urination before food is digested? Qibo explained: Alcohol is a fermented grain liquid—its nature is clear, swift, and potent. Thus, though ingested later than food, it is expelled first.

The Yellow Emperor concluded: I understand now. The Upper Burner resembles mist steaming upward, the Middle Burner like fermentation in a vat, and the Lower Burner functions as drainage ditches—these are the characteristics of the Three Burners.

(Four Seasons Qi Chapter)

The Yellow Emperor asked Qibo: The four seasons differ in climatic influence, causing varying illnesses—how should acupuncture principles be determined accordingly? Qibo answered: Each season's Qi has distinct qualities; acupuncture treatment must adapt to these seasonal characteristics.

The passage primarily discusses acupuncture treatment methods tailored to different seasons and disease characteristics.

During spring treatment, for conditions between the meridians, blood vessels, and muscles, severe cases require deep needling while mild cases call for shallow insertion. In summer, practitioners should select flourishing meridians and fine collaterals, inserting needles between muscle layers to penetrate the skin. Autumn treatment focuses on meridian points, choosing He-sea points when pathogenic qi resides in the fu organs (hollow viscera). Winter treatment requires selecting Jing-well and Ying-spring points, necessitating deep insertion with prolonged needle retention.

Specific treatments are prescribed for different conditions: For warm malaria without sweating, fifty-nine points are needled; for wind-water edema with skin distension, fifty-seven points; for diarrhea with undigested food (sūnxiè), reinforce points on the three yin meridians and Yinlingquan (SP-9), retaining needles until warmth is felt. For muscle cramps (zhuǎnjīn), treat yang meridians when occurring in yang channels and yin meridians in yin channels, both using swift needling techniques.

For edema treatment, first use a sword needle three cun below Huangu point, followed by repeated insertion and withdrawal of a tube needle to drain excess fluid. Needling should be accompanied by obstruction-relieving herbs, avoiding food while taking medicine and abstaining from medicine while eating, with dietary restrictions maintained for 135 days. For stubborn bi-syndrome or prolonged cold conditions unresponsive to treatment, urgently needle Zusanli (ST-36).

For intestinal dysfunction, use drainage for excess patterns and supplementation for deficiency patterns. Treat leprosy by first needling swollen areas, then using sharp needles to release foul qi, stopping when swelling subsides. Abdominal gurgling, qi rushing upward to the chest, and breathlessness preventing prolonged standing indicate pathogens in the large intestine - needle the source of Huang points, Shangjuxu (ST-37), and Zusanli (ST-36).

When the lower abdomen pulls the testicles with lumbar spine pain and qi surging toward the heart (indicating small intestine pathogens), needle Huangyuan points to disperse pathogens, reinforce Taiyin meridians to boost qi, reduce Jueyin meridians to counterflow, select Xiajuxu (ST-39) to eliminate pathogens, and regulate related meridians. For bitter taste and bile vomiting (indicating rebellious gallbladder qi), needle Zusanli (ST-36) to descend stomach qi, puncture shaoyang meridian blood vessels to stop gallbladder rebellion, then regulate excess/deficiency to expel pathogens. Corresponding treatments are also prescribed for food stagnation and chest obstruction.

This scripture discusses the treatment of pathogenic factors (evil Qi) in different bodily regions through acupuncture, and how to assess disease progression by observing pulse conditions and symptoms.

When pathogenic Qi lingers in the gastric region (the upper part of the stomach), if located at the upper gastric orifice (shangwan), needle techniques should be applied to suppress and direct the Qi downward. If at the lower gastric orifice (xiawan), dispersive needling is used to expel the pathogenic Qi. Symptoms like lower abdominal pain with swelling and urinary retention indicate Qi stagnation in the Triple Burner (the body's water passageways), requiring treatment at the major collateral point of the Foot Taiyang channel.

Physicians must examine the patient's superficial collaterals. If finding tangled small collaterals of the Jueyin channel with blood stasis, accompanied by swelling extending to the gastric region, the Zusanli (ST-36) point should be needled. Facial complexion changes reveal whether pathogenic Qi is dissipating, while the spirit (Shen) in the eyes indicates disease persistence.

During pulse diagnosis, comprehensive observation of the patient's physical state and movement patterns is essential, focusing particularly on the Cunkou pulse (radial artery pulse reflecting Yin channels) and Renying pulse (carotid artery pulse reflecting Yang channels). A strong, flooding, and slippery pulse suggests worsening conditions, while a soft pulse indicates impending recovery. Patients with replete channel Qi typically recover within three days. The Cunkou pulse reflects Yin channel conditions, whereas Renying reflects Yang channels.

Three special disorders are mentioned: wind edema (similar to stroke), muscular rigidity (tongzhu), and Bi syndrome (numbness and pain), requiring treatment with sharp needles (lance needles). These teachings originate from the collected commentaries of Volume 8 in the Ling Shu section of the Huangdi Neijing.