Qi

Tranquil and detached, empty and without craving: then true qi follows of itself, essence and spirit are kept within — and where would illness come from?

Qi follows and moves smoothly; each follows what it wants, and all obtain what they wish.

The qi of vigorous fire declines; the qi of gentle fire flourishes. Vigorous fire consumes qi, while qi feeds on gentle fire. Vigorous fire scatters qi; gentle fire engenders qi.

Yin and yang flow on and on; accumulating and passing on, they complete one circuit. Qi is within and form is without, and so the two complete each other.

Therefore, when the hard is joined to the hard, the yang qi is broken and scattered, and the yin qi then wastes away. If there is sodden excess, the hard and the soft are out of harmony, and the qi of the channels is cut off.

The bladder is the office of the regional capital. The fluids are stored there, and once qi transforms them they are able to issue forth.

Heaven feeds people with the five qi; earth feeds them with the five flavours. The five qi enter by the nose and are stored in the heart and lung; rising, they make the five colours bright and clear and let the voice ring out. The five flavours enter by the mouth and are stored in the stomach and intestines; each flavour has its store, and with it the five qi are nourished. When the qi are harmonious there is generation, the fluids are formed in accord, and spirit arises of itself.

All the vessels belong to the eye; all the marrow to the brain; all the sinews to the joints; all the blood to the heart; all the qi to the lung. This is the morning-and-evening traffic of the four limbs and the eight ravines.

Now stomach, large intestine, small intestine, triple burner and bladder — these five are born of the qi of heaven; their qi images heaven, and therefore they discharge and do not store. They receive the turbid qi of the five storing organs. They are named the palaces of transmission and transformation.

Root and tip assist one another, the tip and the root are matched, and the evil qi then submits.

Qibo says: the illness is the root and the practitioner the branch; when root and branch do not meet, the evil qi does not submit. This is what is meant.

A short pulse with the qi cut off is death. Warm disease with severe depletion is death.

Qibo replies: In the first and second months the heavenly qi begins to spread squarely and the earthly qi begins to issue forth, and the human qi is in the liver. In the third and fourth months the heavenly qi is squarely in place and the earthly qi issues in earnest, and the human qi is in the spleen. In the fifth and sixth months the heavenly qi is at its height and the earthly qi is high, and the human qi is in the head. In the seventh and eighth months the yin qi begins to kill, and the human qi is in the lung. In the ninth and tenth months the yin qi begins to freeze and the earthly qi begins to close, and the human qi is in the heart. In the eleventh and twelfth months the ice thickens and the earthly qi closes up, and the human qi is in the kidney.

The pulse is the storehouse of the blood. If it is long, the qi is in order; if short, the qi is diseased; if rapid, the heart is vexed; if large, the illness is advancing. If the upper part is full, the qi rides high; if the lower part is full, the qi is distended. An intermittent pulse means the qi is failing; a thin pulse means the qi is scant; a rough pulse means pain in the heart. A pulse that comes turbulent and urgent like a gushing spring means the illness is advancing and the complexion is deteriorating; one that departs faint and faint, like a bowstring snapping, means death.

If on one exhalation the pulse moves once and on one inhalation once, this is called scant qi.

The five viscera receive qi from what generates them, transmit it to what they conquer, lodge qi in what generates them, and die at the hands of what they cannot conquer. When disease is about to kill, it first travels to the quarter the viscus cannot conquer, and then the patient dies. This is qi moving counter to the order — hence death.

Thus in the lower sector, heaven probes the liver, earth probes the kidney, and the human probes the qi of spleen and stomach.

At such a time, in the brave the qi moves on and there is an end of it; in the timid it lodges and becomes disease.

The Emperor asks: Bring a person’s bodily form together with the four seasons and the five phases and take them as the pattern for treatment. What is it to follow, and what is it to go against? I wish to hear how the matter is gained and lost. Qibo replies: The five phases are metal, wood, water, fire and earth. They are by turns noble and by turns base. By them one knows death and life and decides success and failure, and by them one fixes the qi of the five viscera, the times of abatement and aggravation, and the term of death and life.

The constants of a person: greater yang is regularly plentiful in blood and scant in qi; lesser yang is scant in blood and plentiful in qi; yang brightness is plentiful in both qi and blood; lesser yin is scant in blood and plentiful in qi; ceasing yin is plentiful in blood and scant in qi; greater yin is plentiful in qi and scant in blood. These are the constants of heaven.

Qibo says: The human being is born from earth, but hangs its allotted life from heaven. When the qi of heaven and earth conjoin, that is what is called a human being.

The classic speaks of the waxing and waning of qi, of its tipping and shifting to left and right, of treating the lower by means of the upper and the right by means of the left, of surplus and insufficiency, and of supplementing and draining at the bloom and transport points. All this I know.

Qibo answers: where evil qi is exuberant, that is repletion; where the essential qi has been taken away, that is vacuity.

Qibo says: yang is the qi of heaven and governs the outside; yin is the qi of earth and governs the inside.

Qibo says: Yangming governs the flesh, and its vessel is abundant in blood and qi. When evil lodges in it, heat results; and when the heat is extreme, the patient is averse to fire.

Qi Bo says: where the evil gathers, the qi there is inevitably vacuous.

The Emperor asks: there are those with counterflow qi who cannot lie down and whose breathing is audible; those who cannot lie down and whose breathing is silent; those who rise and rest as usual yet whose breathing is audible; those who can lie down but pant when they walk; those who cannot lie down and pant when they cannot walk; and those who cannot lie down and pant when they lie down.

The malarial qi: merged with yang, yang prevails; merged with yin, yin prevails. Yin prevailing means cold, yang prevailing means heat.

Malaria of the foot ceasing yin makes the lower back ache and the lower abdomen feel full; the urine does not flow freely, so that it looks like blockage — yet it is not blockage, for the person passes urine often. He is fearful, short of qi, and oppressed within the belly. Needle the foot ceasing yin.

Transmitted further it becomes nosebleed, defiled blood and darkened sight — all of it, then, is got from counterflow of qi.

All of these gather in the stomach and bear on the lung; they make a person produce much snivel and spittle, and the face becomes puffy with counterflowing qi.

I understand that the hundred illnesses are born of qi: anger makes qi rise, joy slackens it, sorrow dissolves it, fear sinks it, cold draws it in, heat lets it leak, fright disorders it, labour consumes it, thought knots it.

Even so, though the illness is on the point of settling, in season it will still be there as before — for the qi is gathered in the abdomen.

Qi Bo answers: wind qi lodges between the skin and the flesh; it cannot pass inward and cannot drain outward.

Qi Bo replies: the three qi of wind, cold and dampness arrive mingled together, and combining, they become obstruction.

Grief and sorrow carried too far sever the pericardium’s connecting vessel; once it is severed yang qi stirs within, and the attack brings a collapse below the heart and frequent bloody urine.

Such a person is robust in constitution, yet through autumn and winter he is robbed by his own spending; the lower qi struggles upward and cannot recover, essence qi spills away below, and the evil qi follows it upward.

The Emperor asks: how is it treated? Qi Bo says: take away his food and it stops. Food enters into yin and makes qi grow in yang; therefore taking away his food stops it.

This is what is called obtaining five excesses and two insufficiencies. The Emperor asks: what are the five excesses and the two insufficiencies? Qi Bo answers: the five excesses are the qi of five disease signs in excess; the two insufficiencies are likewise the insufficiency of the qi of the illness.

A pulse arriving like a gushing spring, floating and beating up within the flesh, means the qi of the greater yang is spent; there is scant qi and loss of taste, and the person dies when the chives flower.

What is called deafness because of floating: it lies entirely in the qi.

Do not needle one who is deeply drunk: it makes the qi disordered.

Qibo answers: when qi is replete the body is replete, when qi is vacuous the body is vacuous — this is the constant, and to be the reverse of this is illness.

Qibo answers: as for 「needling vacuity in order to fill it」 — there is heat beneath the needle, for it is qi becoming replete that is hot.

Where there is a gathering in the lesser abdomen, needle from below the 皮𩩻 — the crease five inches below the navel — down as far as the lesser abdomen, and stop there; needle too between the fourth vertebra on either side of the spine, and the liáo points over the two haunch bones in the space of the short ribs, leading the qi and heat within the abdomen downward until the trouble is done.

When evil overflows and the qi is dammed, the vessels are hot and the flesh spoils; construction and defence cannot move, and it must turn to pus.

What the qi of the foot greater yang vessel sends forth is seventy-eight points: one at each of the two ends of the brows.

Where the qi rises and there is a sound in the breathing, treat the centre of the throat — the point that lies between the two empty basins.

When both are affected, it is because the water qi has lodged there.

Qi Bo says: the spirit has its excess and its insufficiency; so have the qi, the blood, the body and the will. These ten are not alike in their qi.

Its qi has no fixed place, and it does not enter the transport points of the channels. This is what is named contralateral puncture.

To do the opposite is to engender disordered qi, which encroaches and spreads, and illness comes of it.

Heaven and earth are the above and below of the ten thousand things; left and right are the roadway of yin and yang; water and fire are the signs of yin and yang; metal and wood are the ending and the beginning of generation and completion. Qi has its greater and lesser measures, form its flourishing and decline. Above and below call to one another, and so loss and gain are made manifest.

Qi Bo said: the great qi holds it up. Dryness dries it, summer heat steams it, wind moves it, dampness moistens it, cold hardens it, fire warms it. And so wind and cold are below, dryness and heat above, damp qi in the middle, and fire wanders through between them; cold and summer heat enter in six ways, and this is what lets the emptiness bring forth generation and transformation.

Huang Di said: I wish to hear how it acts. Qi Bo said: having risen it then descends, and what descends belongs to heaven. Having descended it then rises, and what rises belongs to earth. The qi of heaven descends and flows into the earth; the qi of earth rises and mounts to heaven. Thus high and low call to one another, rising and falling depend on one another, and change is made.

Qi Bo said: they move by receiving from heaven, and so they do not move wildly and there is nothing they do not answer to. What stirs of a sudden is the meeting and change of the qi, and they do not answer to it. Hence it is said: they answer to the constant and do not answer to the sudden. This is what that means.

When the sages of high antiquity taught those below them, they all said this: as for the deficient evils and thieving winds, avoid them in season; be tranquil and detached, empty and without striving, and the true qi will follow you; keep essence and spirit guarded within, and from where could illness come? Therefore the will is at leisure and desires are few, the heart is at peace and knows no fear, the body labours and does not weary. The qi follows and goes smoothly, each follows what he wishes, and all obtain what they want. So they find their food sweet, they are easy in their clothes, they delight in their customs, and high and low do not envy one another — such people may be called the uncarved. Hence craving cannot weary their eyes and debauchery cannot confuse their hearts; the foolish, the wise, the worthy and the worthless alike are not made fearful by things, and so they accord with the way.

The three months of winter are called the shutting in and the storing. Water is ice and the earth is split; do not disturb the yang. Sleep early and rise late, and always wait for the light of the sun. Make the will as though it were lying low, as though it were hidden, as though one held a private thought, as though one had already gained something. Leave the cold and draw near to the warm; do not let anything out through the skin, or the qi will be taken from you again and again. This is the answer to the qi of winter, and it is the way of nourishing the storing. Going against it harms the kidney; in spring there is flaccidity and inversion, and there is little to hand on to what must come to life.

Therefore the sage sets out yin and yang: the sinews and vessels are of one accord, the bone and marrow are firm, and the qi and blood all follow. Then inner and outer are in tune, nothing evil can do harm, hearing and sight are clear, and the qi stands as it did before.

Therefore it is said: one who does not know what the year brings upon it and the sameness and difference of the qi is not fit to speak of engendering and transforming. This is what it means. Huang Di said: when the qi begins there is engendering and transforming, when it scatters there is form, when it spreads there is increase and nurture, when it ends the image changes — their reaching is one. Yet that on which the five flavours draw has its thin and its thick, its ripening has its little and its much, and the end and the beginning are not alike — what is the reason?

Qi Bo bowed his head to the ground, bowed twice again, and answered: how bright the question is! This is the guiding order of heaven and earth, the wellspring of transformation and change. But for a sage emperor, who could exhaust its ultimate principle? Though I am not quick, let me set out its way, so that it never perishes and long endures unchanged. Huang Di said: I would have you push it through and set it in order — by its kinds, its allotments and governors, distinguishing its ancestral offices, making bright its qi and numbers and clear its upright transformation. May I hear it? Qi Bo said: first establish the year to make its qi clear. The numbers of the circuit of metal, wood, water, fire and earth, and the transformations by which cold, heat, dryness, dampness, wind and fire come down and govern — then the way of heaven can be seen and the people’s qi tuned; yin and yang roll up and spread out, and what lies near is without confusion. The numbers that can be counted — let me speak of them fully.

Huang Di said: what is meant by the three grades? Qi Bo said: it is to make plain the different kinds of good and evil in drugs. Huang Di said: good. What of illness within and without? Qi Bo said: in the formula that tunes the qi one must distinguish yin and yang, fix the inner and the outer, and let each keep to its own quarter: what is within treated from within, what is without treated from without; what is slight, tune it; what is next, level it; what is full, take it away. What should sweat, carry it down. Cold, heat, warm and cool are lessened according to what they belong to, following where it benefits. Walk carefully by the law, and ten thousand undertakings in ten thousand are whole; the blood and qi are upright and level, and a man’s heavenly span is long. Huang Di said: good.

Huang Di said: the three yang are the utmost yang. Piled up and joined they make fright; the illness rises like a swift wind and arrives like a thunderbolt; the nine openings are all stopped, the yang qi floods over, the gullet dries and the throat is blocked. Joined into the yin, above and below lose their constancy, and pressing in they make a flux of the bowel. This is what is meant by the three yang running straight into the heart: a man cannot rise from sitting, and lying down his body is at ease. What has been said is the illness of the three yang, and from it one may know all under heaven — how to tell yin and yang apart, answer the four seasons, and join them to the five phases.

To be timid and short of breath is the water course not moving and the bodily qi wasting away; to cough and be oppressed is the kidney qi rebelling. A single man’s qi falls ill in a single viscus; to say that all three viscera act together is not within the rule.

In the way of treating illness, the qi kept within is the treasure; one follows and seeks out its principle. Seek it and not find it, and the fault lies in the outer and the inner. Keep to the numbers and treat according to them, and do not miss the principle of the transport points. Able to practise this art, one is never in danger all one’s life. Not knowing the principle of the transport points, the five viscera are pent up and ripen, and abscesses break out in the six receptacles. To diagnose without care is called losing the constant. Keep this treatment carefully, and it will be clear together with the canon.

At the very beginning of spring, Huang Di sat at his ease, looked out to the eight extremities, and set in order the qi of the eight winds. He asked Lei Gong: Of the classes of yin and yang, the way of the channels, and what each of the five viscera governs — which viscus is the most noble?

Lei Gong asked: “In the quantity of qi, which is the contrary and which is the compliant?”

Then the spirit’s qi passes into the heart’s essence and does not pass upward to the will, and the will grieves alone; therefore the tears come out.

Qibo says: In every method of needling, one must watch for the qi of sun and moon, of stars and constellations, of the four seasons and the eight standards; only when that qi has settled does one needle.

The Yellow Emperor asked Qi Bo: I treat the people as my children, nourish the common folk and collect their taxes; I grieve that they cannot provide for themselves and that sickness comes upon them. I wish to spare them the harm of toxic drugs and to do without stone needles, using only fine needles to open the channels and vessels, regulate the blood and qi, and keep the meetings where the contrary and the accordant enter and leave. Let this be handed down to later generations: it must be made into a clear method, so that it never dies out, endures without break, is easy to use and hard to forget. Give it a framework, distinguish its sections, separate the exterior from the interior. Give it a beginning and an end, so that each has its own form. First establish the Needle Classic; I wish to hear its essentials.

In spring take the network vessels, the several spring points, and the spaces between the muscles along the great channels: for severe cases needle deep, for light cases needle shallow. In summer take the several stream points, the minute network vessels, and the surface of muscle and skin. In autumn take the several sea points, the rest as in spring. In winter take the several well points and the divisions of the several stream points, and needle deep and retain. This is the order of the four seasons — where qi resides, where disease lodges, and what each zang requires. For cramp, have the patient stand and needle; the seizure can be stopped at once. For flaccidity and reversal, have him stretch out and needle; he can be made easy at once.

What is called easy to set forth means easy to speak of. Hard to enter means hard to apply to a person. The coarse guard the form means they guard the method of needling. The superior guard the spirit means they guard the excess and deficiency of the person’s blood and qi and can supplement and reduce. Spirit and guest means the upright and the evil meet together. The spirit is the upright qi; the guest is the evil qi. At the gate means the evil follows where the upright qi goes out and in. Not yet seeing the disease means first knowing in which channel the evil and the upright are contending. How know its source means first knowing of which channel the disease is, and the place to be taken.

Huang Di asked Qi Bo: When evil qi strikes a person, how is it? Qi Bo answered: The place where evil qi strikes a person is high.

Qi Bo said: Heaven and earth affect one another, cold and warmth shift into one another. In the way of yin and yang, which is few and which is many? The yin way is even, the yang way is odd. When it issues in spring and summer, yin qi is few and yang qi is many; yin and yang are not regulated — what is supplemented and what is reduced? When it issues in autumn and winter, yang qi is few and yin qi is many; yin qi is abundant and yang qi declines, and so stems and leaves wither and dry, and wet rain descends and returns. Yin and yang shift into one another — what is reduced and what is supplemented? Strange evil departs from the channels beyond all counting; and if one does not know root and knot, the five zang and six fu will snap their passes and ruin their pivots, open and close and run away, and yin and yang will be greatly lost and cannot be taken again. The mystery of the nine needles lies in beginning and end: therefore one who knows beginning and end finishes in a single word, and one who does not, has the way of the needle entirely cut off.

Huang Di asked Bo Gao: I have heard that in disease of form and qi there is a sequence of before and after, and a response of inner and outer. What is it?

The essence of needling lies in the official needles, which are the most subtle instrument. Each of the nine has its proper use and its proper work; long and short, large and small, each has that to which it is applied. If they are not used according to their use, the disease cannot be moved. When the illness is shallow and the needle goes deep, the good flesh is injured within and the skin becomes a sore. When the illness is deep and the needle is shallow, the diseased qi is not drained and gathers into a great pus. When the illness is small and the needle large, the qi is drained too far and harm must follow. When the illness is great and the needle small, the qi is not drained and ruin follows as well. Losing the fitness of the needle, the large drains too much and the small does not remove. Having spoken of these faults, I ask leave to speak of their application.

Huang Di asked Qi Bo: in all methods of needling, one must first be rooted in the spirit. Blood, vessels, ying, qi, essence and spirit — these are what the five zang store. When they overflow and leave the zang, the essence is lost, the hun and po fly up, will and intention are thrown into confusion, and wisdom and deliberation depart from the body. By what cause does this happen? Is it the fault of early death, or the fault of man? What are called virtue, qi, life, essence, spirit, hun, po, heart, intention, will, thought, wisdom and deliberation? I beg to hear the reason.

The way of needling is complete in beginning and end. When beginning and end are clearly known, and the five zang are taken as the rule, yin and yang are settled. Yin governs the zang, yang governs the fu. Yang receives its qi from the four extremities, yin receives its qi from the five zang. Therefore the reducing method meets it, the supplementing method follows it. Knowing how to meet and how to follow, one can bring the qi into harmony. The way to harmonise qi must pass through yin and yang: the five zang are yin, the six fu are yang. Hand this down to later generations, sealing it with blood. Those who revere it flourish; those who slight it perish. To practise privately without the Way is to invite Heaven’s calamity.

Huang Di said: when man first comes to life, essence is formed first; when the essence is formed, the brain and marrow arise; the bones become the frame, the vessels the camp, the sinews the strength, the flesh the wall; the skin is made firm and the hair grows. When grain enters the stomach, the vessel way is opened, and blood and qi begin to move.

Huang Di asked Qi Bo: the twelve channels correspond outwardly to the twelve water-courses and inwardly connect with the five zang and six fu. Now the twelve water-courses differ in size, depth, breadth and distance, and the five zang and six fu differ in height and size and in how much grain they receive. How do they correspond? The water-courses receive water and move it; the five zang gather spirit, qi, hun and po and store them; the six fu receive grain and transmit it, receive qi and spread it; the channels receive blood and nourish with it. How are these combined in treatment? May I hear about the depth of needling and the number of moxa cones?

The sinews of foot jueyin begin above the great toe, knot in front of the inner ankle, ascend the shin, knot below the inner shin bone, ascend the inner thigh, knot at the genitals and net all the sinews. Its diseases: the great toe pulls, there is pain in front of the inner ankle, pain at the inner shin bone, pain in the inner thigh, cramping, and the genitals are useless. If injured within, the organ will not rise; if injured by cold the genitals draw in; if injured by heat they stretch out and will not gather. Treat by moving the water and clearing the yin qi. Where there is cramping, treat with heated needle and swift piercing, taking recovery as the measure and the painful spot as the point. It is called the last-autumn bi.

From the hairline at the nape down to the spinal bone is two cun and a half. From the spinal bone down to the sacrum there are twenty-one vertebrae, three chi long. The upper vertebra is one cun and a fraction of four; the odd fraction lies below, so the upper seven vertebrae down to the spinal bone come to nine cun and seven eighths. This is the bone measure of an ordinary man, and it is what the length of the channels is based on. Hence when one looks at the channels in the body, those that appear floating and hard, or bright and large, have much blood; those fine and deep have much qi.

Qi Bo replied: Heaven circles through twenty-eight mansions, each of thirty-six fen, and a man’s qi travels one circuit in one thousand and eight fen, while the sun moves through the twenty-eight mansions. The channels of man, above and below, left and right, front and back, are twenty-eight vessels, and around the body they measure sixteen zhang and two chi, answering to the twenty-eight mansions. The clepsydra drops a hundred marks, dividing day from night. Thus with one exhalation the pulse beats twice and qi moves three cun; with one inhalation the pulse beats twice again and qi moves three cun. Exhalation and inhalation together make one breath, and qi moves six cun. In ten breaths qi moves six chi and the sun moves two fen.

Huang Di said: In the course of the camp qi, the essence of grain and water is the treasure. Grain enters the stomach and is transmitted to the lungs; it overflows within and spreads without. Its purest part moves through the channel tunnels, circulating without cease, ending and beginning again — this is called the order of Heaven and Earth.

Altogether this makes sixteen zhang two chi — the great channel tunnels through which the qi travels.

Huang Di asked Qi Bo: Where does man receive the qi? Where do yin and yang meet? What qi is the camp, what qi the guard? From where is the camp born, and where does the guard meet? Old and young differ in qi, and yin and yang occupy different positions; I should like to hear where they meet.

Huang Di asked Qi Bo: The qi of the four seasons has different forms, and the rise of every disease has its source; in the way of moxa and needling, what is the standard?

When evil is in the lungs the skin hurts, there is chill and fever, the qi rises and the patient pants, sweats, and coughs so that the shoulders and back are shaken. Take the shu points on the outer side of the chest and the five viscera shu beside the third vertebra of the back. Press quickly with the hand; where the patient feels relief, needle there; take also the supraclavicular fossa to disperse it.

For yang-ying headache with fullness in the chest and inability to breathe, take Renying. For sudden loss of voice with stiff qi, take Futu and the root of the tongue, letting blood. For sudden deafness with qi clouded and ear and eye unclear, take Tianyou. For sudden cramping, seizure and dizziness with the feet unable to bear the body, take Tianzhu. For sudden heat disease with internal rebellion, liver and lung contending, blood overflowing from nose and mouth, take Tianfu. These are the five parts of Tianyou.

In bone seizure the cheek, the teeth, the transports and the interstices are all full, and the bone holds the evil deep; there is sweat, vexation, copious frothy vomiting and qi leaking downward. Not treated.

For qi filling the chest with panting, take the tip of the great toe of foot taiyin, a leek-leaf’s breadth from the nail. If cold, retain the needle; if hot, needle quickly; stop when the qi descends.

In wind bi with profuse soaking that cannot be ended, the foot feels as if treading ice and now and then as if steeped in hot water; thigh and shank are soaked, the heart vexed, the head painful, with vomiting and stuffiness from time to time. Dizziness passes into sweating; in time the eyes darken, sorrow comes with easy fear, breath is short and joy is gone. Within three years, death.

For jue with qi rushing to the throat so that the patient cannot speak, cold hands and feet and no movement of the stool, take foot shaoyin.

Qibo replied: wind, cold and damp qi lodge in the interstices outside; pressed together they become foam, and the foam, meeting cold, congeals. Congealing, it pushes apart the flesh and splits it. The splitting is pain; pain draws the spirit to it; the spirit there generates heat; heat dissolves the pain; the pain dissolved, there is reversal; and reversal brings on another bi, which arises in just this way.

Qibo answered: the beginning of the hundred diseases is always born of wind and rain, cold and heat, yin and yang, joy and anger, food and drink, dwelling and rest. Great fright and sudden terror separate the blood and qi, break yin and yang, cut off the channels and network vessels, obstruct the vessel roads, turn yin and yang against each other, hold back the guard qi, empty the channels, and put blood and qi out of order. What is not discoursed in the canon — let me set out its methods.

Qibo said: how far-reaching a question! To govern the people and to govern oneself, to treat others and to treat oneself, to treat the small and to treat the great, to govern a state and to govern a household — none of these can be done by opposing; only by compliance. Compliance is not only the compliance and reversal of yin and yang in the pulse; the hundred families and the people all wish their wills to be complied with.

Qibo said: the upper burner opens and diffuses the flavours of the five grains, steaming the skin, filling the body, moistening the hair like mist and dew irrigating — this is called qi.

Bo Gao said: Let me state the reason. The stomach is one chi and five cun in girth, five cun across and two chi and six cun long; bent crosswise, it receives three dou and five sheng of water and grain, of which two dou of grain are always retained, and it is full with a dou and five sheng of water. The upper jiao disperses qi and sends out its essence, swift and fierce and slippery and rapid. The lower jiao irrigates the intestines below.

The Yellow Emperor asked Qi Bo: I have heard the method of needling from you, Master, and all you say turns on camp and guard, blood and qi. The twelve channels within join the fu and zang, without they net the limbs and joints: can you join them to the four seas?

Qi Bo said: The twelve channels answer to the twelve months; the twelve months are divided into the four seasons; the four seasons are spring, summer, autumn and winter, and their qi differs one from another. When camp and guard follow one another, when yin and yang are already harmonious, and when clear and turbid do not encroach on each other, that is following, and following governs.

The Emperor said: When qi makes a person distended, is it within the blood and vessels, or within the zang and fu?

The Yellow Emperor asked Qi Bo: Water and grain enter the mouth and are conveyed to the stomach and intestines; their liquid divides into five. When the weather is cold and the clothes thin, it becomes urine and qi; when the weather is hot and the clothes thick, it becomes sweat; when sorrow gathers the qi, it becomes tears; when there is inner heat and the stomach is slack, it becomes spittle. When evil qi rebels within, the qi is blocked and does not move, and what does not move becomes water distension. I know this is so, but not whence it arises; I should like to hear the way of it.

The Yellow Emperor asked Qi Bo: I have heard that in needling there are five offices and five readings by which the five qi are observed. The five qi are the envoys of the five zang and the counterparts of the five seasons. I should like to hear where the five envoys come forth.

Qi Bo said: Opening a channel above a deep pool lets the water run dry without effort; following a dug course and clearing the rush lets the channel be opened. This speaks of the slippery and the rough in qi, the clear and the turbid in blood, the opposing and following of their movement.

Qi Bo said: When vessel qi is full and blood deficient, needling loses the qi, and losing qi one faints.

The Yellow Emperor said: I have heard that the twelve channels answer to the twelve channel-waters, whose five colours differ and whose clear and turbid are not the same; but if human blood and qi are one, how do they answer?

The Yellow Emperor said: All diseases, when they first arise, must start from dryness and dampness, cold and heat, wind and rain, yin and yang, joy and anger, food and drink, dwelling and rest. Qi combines and takes form; it finds a viscus and takes a name. This I know. But most diseases are clear in the morning, quiet by day, worse at dusk and severe at night. Why?

Shao Yu answered: Such a person has thin skin and eyes that are firm and deep-set, with a long upward thrust. His heart is hard, and hardness gives much anger; anger drives the qi upward, so that it accumulates in the chest and the blood and qi run counter and remain. The skin is stretched and the flesh filled; the blood vessels do not move; it turns to heat, and heat consumes the flesh and skin, and so there is consumption and wasting. This speaks of one who is violently hard in temperament and weak in flesh.

The Yellow Emperor asked Qi Bo: Man’s blood, qi, essence and spirit are what sustain life and pervade the constitution. The channels are what move the blood and qi, regulate yin and yang, moisten sinew and bone, and free the joints. The defensive qi is what warms the flesh, fills the skin, fattens the pores, and governs opening and closing. The will is what drives the spirit, gathers the souls, adapts to cold and warmth, and harmonises joy and anger.

The Emperor said: Both within and without are present. Press the pulse mouth: if it is slippery, small, tight and deep, the illness worsens, and it is within. If the qi of the man’s ying is large, tight and floating, the illness worsens, and it is without.

The Emperor said: Whether a person endures pain or does not endure it is not a matter of courage and cowardice. The brave man who cannot endure pain presses forward when he sees danger but stops when he feels pain; the coward who can endure pain is frightened when he hears of danger but does not move when pain comes. The brave man who can endure pain neither fears danger nor moves under pain. The coward who cannot endure pain, meeting both danger and pain, rolls his eyes and looks askance, is too frightened to speak, his qi scatters and his spirit starts, his complexion changes, and he seems now to die and now to live. I have seen this, but do not know its cause; I wish to hear the reason.

Qi Bo said: This is the clear evidence — it is the stomach channel. The stomach is the sea of the five viscera and six bowels; its clear qi flows upward to the lungs, and the lung qi moves along the taiyin. Its movement goes with the breath, so that with one exhalation the pulse beats twice, and with one inhalation it beats twice again. Breathing does not stop, and therefore the movement does not stop.

Sour goes to the sinews, and eating it in excess makes a person’s urine stop. Salty goes to the blood, and eating it in excess makes him thirsty. Pungent goes to the qi, and eating it in excess makes the heart feel hollow. Bitter goes to the bones, and eating it in excess turns him to vomiting. Sweet goes to the flesh, and eating it in excess makes the heart feel oppressed.

Bo Gao said: Between heaven and earth, within the six directions, nothing is apart from the five, and man answers to them as well. Hence there is the government of five times five, twenty-five kinds of people, and the yin and yang people are not among them. There are also five whose forms do not fit the crowd, and these I already know. I should like to hear the forms of the twenty-five, how their blood and qi are generated, how they are distinguished and examined, and how one knows the inside from the outside.

The Yellow Emperor said: When a woman has no beard, is it that she has no blood and qi?

The Yellow Emperor asked Qi Bo: When the hundred diseases first arise, they all come from wind and rain, cold and heat, clear damp, and joy and anger. When joy and anger are uncontrolled they injure the viscera; wind and rain injure the upper; clear damp injures the lower. The qi of the three parts is injured by different things; I should like to hear how they meet.

The Yellow Emperor asked Qi Bo: I have heard the nine needles from you and put them into practice among the people. The blood and qi of the people are not of one form: in some the spirit stirs and the qi moves ahead of the needle; in some the qi meets the needle; in some the qi travels alone after the needle is out; in some several insertions are needed before there is any awareness; in some the qi reverses as the needle is withdrawn; and in some several insertions make the disease worse. These six are of different forms; I should like to hear the reasons.

The Yellow Emperor said: When qi forms an obstruction above the diaphragm, food and drink enter and come back out — I know that already. When worms form an obstruction below the diaphragm, food comes out only after a full day and night, and I have not grasped the meaning of it. I wish to hear it to the end.

The Yellow Emperor asked Shao Shi: When a person is suddenly overcome by sorrow and anger and loses his voice, what road is blocked, what qi goes out, so that the sound does not come through? I should like to hear the reason.

The Yellow Emperor asked Qi Bo: The cold-and-heat scrofula that appears at the neck and armpit — what qi brings it about?

The Yellow Emperor asked Bo Gao: When evil qi lodges in a person it sometimes keeps the eyes from closing so that he cannot lie down — what qi brings this about?

Shao Shi said: There are the greater yin man, the lesser yin man, the greater yang man, the lesser yang man, and the man of yin-yang peace. These five differ in bearing, and their sinews, bones, qi and blood are each unequal.

The Emperor said: In the principle of using the needle one must know where form and qi are, left and right, above and below, yin and yang, outside and inside, whether blood and qi are much or little, whether movement is adverse or smooth, the meeting of exit and entry, and plan the attack on what is at fault. Know how to untie knots, know how to tonify emptiness and drain fullness, the qi gates above and below, and be clear about the four seas, examining where they are; cold, heat, dripping dew — each has its different transport.

When the hollow above the eye is slightly swollen, as after first rising from sleep, when the neck pulse beats and there is occasional cough, and when pressing the hands and feet leaves a pit that does not rise, it is wind-water and skin swelling. If the skin is slippery and glossy, it is wind. If the flesh of the cubit is weak, with laziness, lying down and wasting, cold and heat will not be cured. If the cubit skin is slippery and oily, it is wind; if rough, it is wind obstruction. If the cubit skin is coarse like the scales of a dried fish, it is water overflowing as drink. If the cubit skin is very hot and the pulse full and restless, it is a warm disease; if the pulse is full and slippery, the illness is about to come out. If the cubit skin is cold and the pulse small, there is diarrhoea and lack of qi. If the cubit skin burns and there is heat first and cold after, it is cold and heat; if the cubit skin is cold first and grows hot under long pressure, it is also cold and heat.

Qi Bo said: Shaking off the dust is when yang qi rebels greatly and fills the chest above, with angry resentment and shoulder-raised breathing, the great qi rebelling upward, panting and sitting bowed, the sick man hating dust and smoke, choked so that he cannot breathe. Let me speak of shaking off the dust: it is faster than shaking off dust. The Emperor said: Good. Where is it taken? Qi Bo said: At Tian Rong.

The Yellow Emperor asked Qi Bo: I wish to hear of the movement of guarding qi, and of the meeting of its going out and coming in.

Wind from the south is called the great weak wind; when it injures a man it lodges in the heart, appears in the vessels, and its qi governs heat. Wind from the southwest is called the plotting wind; it lodges in the spleen, appears in the flesh, and its qi governs weakness. Wind from the west is called the hard wind; it lodges in the lung, appears in the skin, and its qi governs dryness. Wind from the northwest is called the breaking wind; it lodges in the small intestine, appears in the hand greater yang vessel; if the vessel is cut off it overflows, if closed it knots and does not pass, and men often die suddenly. Wind from the north is called the great hard wind; it lodges in the kidney, appears in the bone and in the spinal sinews of shoulder and back, and its qi governs cold. Wind from the northeast is called the fierce wind; it lodges in the large intestine, and appears below the ribs and armpits and in the joints of the limbs. Wind from the east is called the infant wind; it lodges in the liver, appears at the sinew knots, and its qi governs dampness of the body. Wind from the southeast is called the weak wind; it lodges in the stomach, appears in the flesh, and its qi governs heaviness of body.

One is heaven. Heaven is yang; among the five viscera the one answering to heaven is the lung, and the lung is the lid of the five viscera and six bowels; the skin is the lung’s joining, and is man’s yang. So for this needle one must make its head large and its tip sharp, so that it cannot go deep and the yang qi comes out.

Qi Bo answered: When evil lodges at the wind palace, the illness follows the spine downward; guarding qi gathers greatly at the wind palace once in a day and a night, and on the next day it descends one joint, so the attack comes a day later — this is because the evil first lodged in the spine and back. Hence whenever it reaches the wind palace the interstices open; opening, evil enters; entering, the illness breaks out: this is why the daily attack comes later and later. As guarding qi moves from the wind palace down one joint a day, on the twenty-first day it reaches the tail bone, and on the twenty-second enters within the spine and pours into the hidden thoroughfare vessel. It travels nine days and comes out in the middle of the collar-bone basin; its qi rises, and so the illness slightly worsens.

The Yellow Emperor asked Qi Bo: I once went up the terrace of clear cool, and looking back from the middle stair, then crawling forward, I became bewildered. I wondered at it privately and was puzzled within. Standing alone and looking alone, calming my heart and steadying my qi, for a long while I could not undo it. Dizzy and reeling alone, hair unbound and kneeling long, bowing to look, for a long while it did not stop, and suddenly it was as if I fell from above. What qi brings this about?

The Emperor said: I have heard that when stomach and intestines receive grain, the upper burner issues qi to warm the flesh, nourish the joints and open the interstices.