Yin and yang

The people of high antiquity who knew the Way took yin and yang as their pattern and lived in harmony with the computed arts.

Thus it is said: within yin there is yin, within yang there is yang.

Yin and yang are the Way of heaven and earth, the framework of the myriad things, the father and mother of all change, the root and beginning of life and death, and the storehouse of spirit brightness. In treating illness one must always seek the root.

Yin and yang can be counted up to ten, and extended to a hundred; counted up to a thousand, and extended to ten thousand. Great as ten thousand is, it cannot be counted out — and yet its essential point is one.

As to what is called yin and yang in the pulse: that which departs is yin, that which arrives is yang; the still is yin, the moving is yang; the slow is yin, the rapid is yang.

From of old, what communicates with heaven is the root of life, and that root lies in yin and yang. Its qi fills the nine regions and opens at the nine orifices, and all of it communicates with the qi of heaven.

Yin and yang are overturned. The treatment lies in weighing and taking from one another: this is the business of the anomalous, and it is the business of assessment.

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 subtle and the minute lie in the pulse, and must be examined. Examination has a rule: begin with yin and yang. The beginning has a standard, born of the five phases; their birth has a measure, and the four seasons are what suit it. Do not err in supplementing and draining; be one with heaven and earth. Grasp the truth of the One, and thereby know life and death. Thus sound accords with the five tones, colour with the five phases, and the pulse with yin and yang.

When the pulse follows yin and yang, the illness is easily ended; when the pulse goes against yin and yang, the illness is hard to end.

Thus: he who distinguishes the yang knows whence the disease came; he who distinguishes the yin knows the term of life and death — that is, he knows it will die on reaching the quarter where it is cornered.

Qibo says: where the pulses of the nine probes are all sunken, thin and cut off — that is yin, and it governs winter — such a one dies at midnight. Where they are exuberant, agitated, panting and rapid — that is yang, and it governs summer — such a one dies at noon.

Thus in spring, autumn, winter and summer, with the yin and yang of the four seasons, the arising of illness comes from use beyond measure; this is the constant rule.

The disorders the five evils make: evil entering yang brings mania; evil entering yin brings obstruction; striking yang it makes disease of the crown of the head; striking yin it makes loss of voice. Yang entering yin brings quiet; yin going out to yang brings anger. This is called the five derangements.

The Emperor says: A person is born with a form and never leaves yin and yang. The qi of heaven and earth conjoins, is divided into the nine regions, and is apportioned into the four seasons.

To treat when the moon’s rim is empty is called confounding the channels: yin and yang cross, true qi and evil cannot be told apart, the evil sinks and lodges, the outside empties and the inside falls into disorder, and the licentious evil rises.

One who does not know the three regions cannot separate yin from yang nor distinguish heaven from earth: earth is watched by earth, heaven by heaven, the human by the human; one regulates by the central depot in order to fix the three regions. Hence it is said: to needle without knowing where the diseased pulse lies among the three regions and nine indicators — even when a great excess is about to arrive, the physician cannot prevent it.

Qibo says: where the network vessels are full and the channels empty, cauterise the yin and needle the yang; where the channels are full and the network vessels empty, needle the yin and cauterise the yang.

Qibo answers: yin and yang stand in different positions. They alternate in vacuity and in repletion, they alternate in counterflow and in compliance; sometimes the illness follows from within, sometimes from without. What it follows from is not the same, and so the illnesses are named differently.

Qi Bo replies: the disease is called yin-yang crossing, and where they cross, there is death.

Qi Bo says: yin and yang, above and below, contend with one another; vacuity and repletion take turns acting; yin and yang shift into each other.

Lung malaria makes the heart cold; when the cold is extreme, heat follows, and in the intervals between the heat the person startles readily, as though he had seen something. Needle the hand greater yin and yang brightness.

Yin and yang together are the meeting of the ancestral sinews; they meet at the qi street, and yang brightness is their chief. All belong to the belt vessel and connect to the governing vessel.

What is called being drained of colour, unable to stand or sit long, and seeing nothing when one rises: the yin and yang of the myriad things are unsettled and nothing yet presides; autumn qi has just arrived, the first light frost has begun to fall and is even now killing the myriad things, while yin and yang are stripped within; hence the dim and useless sight.

The Emperor says: I have heard that the nine needles answer above to heaven and earth, the four seasons, yin and yang; I wish to hear the method of it, that it may be handed down to later generations as a constant.

The Emperor asks: I have heard that the skin has the regions into which it is divided, that the vessels have their warp and rule, that the sinews have their knots and networks, and that the bones have their measure and capacity — and that the illnesses each gives rise to are not the same. I wish to hear how their regions are distinguished, what lies left and right, above and below, where yin and yang are, and how an illness runs from its beginning to its end.

The Emperor says: do the yin and yang of the network vessels answer to their conduits as well?

When the evil of the back and the chest ties together yin and yang, left and right, the illness is pain and sluggishness front and back; pain in the chest and flanks with no resting breath and no lying down; upward surge of qi and shortness of breath; pain on one side. The vessel fills and rises, runs obliquely out towards the seat, nets the chest and flanks, props the heart and pierces the diaphragm, mounts to the shoulder, joins tiān tū, passes obliquely down the shoulder, and crosses below the tenth vertebra.

Qi Bo answers: wind enters from outside. It gives a person shivering, sweating, headache, heaviness of the body and aversion to cold. Treat at Wind Palace and regulate the yin and yang. Where there is insufficiency, supplement; where there is excess, drain.

Qi Bo says: yin and yang each have their meeting places at the transport points. The yang pours into the yin; the yin fills and goes outward. When yin and yang are evenly balanced they fill out the body, and the nine probes are as one. Such a man is called a balanced man.

Qi Bo replies: When evil lodges in the form it must first settle in the skin and the down. If it stays and does not leave it enters the grandchild vessel; if it stays and does not leave it enters the network vessel; if it stays and does not leave it enters the channel vessel, links inward to the five viscera and spreads to the stomach and bowels, so that yin and yang are both affected and the five viscera are harmed. This is the order by which evil enters at the skin and the hair and reaches its extreme in the five viscera. In such a case one treats the channels.

Qi Bo replied: the rule for every puncture is that one must separate yin from yang, let what comes before and what follows answer one another, let what runs counter and what accords each be applied where it belongs, and let root and branch change places with one another.

Heaven uses yang to generate and yin to grow; earth uses yang to kill and yin to store. Heaven has yin and yang, and earth also has yin and yang. Wood, fire, soil, metal, water and fire are the yin and yang of earth, and they are generation, growth, transformation, gathering and storing. Thus within yang there is yin, and within yin there is yang.

Qi Bo said: this is a clear matter. This is the yin and yang of heaven and earth; what can be counted out in numbers is the yin and yang within the human being, yet the numbers by which the two are joined can still be arrived at. As for yin and yang: count them by ten and they extend to a hundred, count them by a thousand and they extend to ten thousand. But the yin and yang of heaven and earth are not to be extended by numbers — they are named by their images.

The governance of the five circuits is like the weight and the beam: what is high is pressed down, what is low is lifted up, what transforms is answered, and what changes is revenged. This is the pattern of growth, maturation, transformation, completion, gathering and storage — the constant of the qi. Lose the constant and heaven and earth are blocked on all four sides. Hence it is said: the movement and stillness of heaven and earth have spirit brightness as their record; the going and returning of yin and yang have cold and summer heat to display their omens. This is what that means.

Qi Bo answered: among the people of high antiquity, those who knew the way took yin and yang as their law and kept themselves in accord with the computed arts; they ate and drank with measure and rose and rested with regularity; they did not labour recklessly. So they were able to keep form and spirit together and come to the end of the years allotted them, passing their hundred before they went.

The yin and yang of the four seasons are the root of the ten thousand things. So the sage nourishes yang in spring and summer and nourishes yin in autumn and winter, following the root; and therefore he rises and sinks with the ten thousand things at the gate of growth. To go against the root is to fell the trunk and ruin the true.

The Yellow Emperor said: from of old, communicating with heaven is the root of life, and this root is itself rooted in yin and yang. Between heaven and earth, within the six directions, the qi of the nine regions, the nine orifices, the five viscera and the twelve joints all communicate with the qi of heaven. Its generating is five and its qi are three – the five phases and the three yin and three yang. To transgress this again and again is to let the evil qi wound the person; this is the root of the allotted span.

Qi Bo said: it is the qi of yin and yang, the pattern of high and low, and the difference of the greater and the lesser. The south-east is yang: what is yang sends its essence down, hence the right is hot and the left warm. The north-west is yin: what is yin offers its essence up, hence the left is cold and the right cool. So the land has its high and its low and the qi its warm and its cool: where it is high the qi is cold, where it is low the qi is hot. Therefore those who go to cold and cool places have distension, and those who go to warm and hot places have sores. Purge downward and the distension stops; induce sweat and the sores stop. This is the constant of the opening and closing of the interstices — only the difference of greater and lesser.

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: good, do not lose it. All of this is yin and yang, outside and inside, above and below, female and male, giving back to one another in turn. And the way knows the patterns of heaven above, the order of the earth below, and human affairs in the middle, and so it can last long. Teach it to the multitude and there is no doubt or danger in it either. A discourse on the way of medicine can be handed down to later ages and kept as a treasure.

Therefore it is said: when the sage treats illness he must know the yin and yang of heaven and earth, the ordering of the four seasons, the five viscera and six receptacles, the female and the male, the outer and the inner, and what needling, moxa, stone and potent drugs each govern; he takes human affairs at ease, so as to make clear the way of the canon; noble and base, rich and poor have each their differing kinds and principles; he asks whether a man is young or grown, and the principle of courage and cowardice; he examines the divisions, knows the root and beginning of the illness, and in the eight upright and the nine indicators his diagnosis must match.

The reason it is not ten in ten is that the spirit is not concentrated and the will and intent are not ordered; outer and inner lose each other, and so at times there is doubt and danger. To diagnose without knowing the principle of yin and yang, of going against and going with — this is the first failure of treatment.

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?

“All these are the deficiency of the five viscera’ qi, with yang in excess and yin insufficient. Join them to the five examinations, tune yin and yang, and seek it in the channels and vessels.” “Diagnosis has ten measures: the measure of the man, of the vessels, of the viscera, of the flesh, of the sinews, of the transport points. When the yin and yang qi are exhausted, the whole illness stands out.” “The movement of the pulse has no constant; yin scatters and yang leans to one side; the pulse qi slips away and is incomplete, so diagnosis has no fixed course.” “One must examine above and below, and weigh whether the patient is a common man or a lord. To receive the teaching of a master and not finish it, so that the art is not clear and the contrary and the compliant are not discerned — this is reckless practice.” “To hold the female and lose the male, to cast off yin and cleave to yang, not knowing how they join — for this the diagnosis is not clear, and handed down to later ages the false doctrine makes itself plain.” “When the utmost yin is deficient, the qi of heaven is cut off; when the utmost yang is full, the qi of earth is insufficient. Yin and yang joining — this is the way the utmost man walks.” “When yin and yang join, the yang qi arrives first and the yin qi after. So the sage’s way of holding the diagnosis is to hold it by the order of yin and yang.” “The configurations of the extraordinary and the constant are sixty in number. To examine what agrees in the finest matters, to pursue the changes of yin and yang, to make plain the conditions within the five viscera,”

“When the spirit is not kind the will does not grieve. Yin and yang hold each other fast: how could the tears come alone?”

Huang Di said: What of the five zang being struck by wind? Qi Bo said: When yin and yang are both affected, then evil can come and go. Huang Di said: Good.

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.

Shao Shi replied: within yin there is yin, and within yang there is yang. When yin and yang are examined and understood, needling has a method. When the point at which the disease began is known, needling has a principle. Measure the beginnings of the illness with care, let it answer to the seasons, join it within to the five zang and six fu, and without to the sinews, bones and skin. Thus there is yin and yang within, and yin and yang without. Within, the five zang are yin and the six fu are yang; without, the sinews and bones are yin and the skin is yang. Hence it is said: for disease in the yin of yin, needle the ying and shu of the yin channels; for disease in the yang of yang, needle the he of the yang channels; for disease in the yin of yang, needle the jing of the yin channels; for disease in the yang of yin, needle the luo vessels. Hence it is said: disease in yang is called wind, disease in yin is called bi, and when both are diseased it is called wind-bi. Disease that has form but no pain belongs to the yang class; that which has no form but pains belongs to the yin class. Where there is no form but pain, the yang is intact and the yin has been injured: treat the yin quickly and do not attack the yang. Where there is form but no pain, the yin is intact and the yang has been injured: treat the yang quickly and do not attack the yin. When yin and yang both move, now with form and now without, and vexation of the heart is added, it is called yin overcoming its yang. This is neither exterior nor interior, and the form will not last long.

Therefore the wise man’s care of life follows the four seasons and suits cold and heat, harmonises joy and anger and rests in his dwelling, moderates yin and yang and tunes the hard and the soft. Thus perverse evil does not reach him, and he lives long and sees far.

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 asked Qi Bo: I have heard that man corresponds to the Way of Heaven. Within he has the five zang, which answer to the five tones, the five colours, the five seasons, the five flavours and the five directions; without he has the six fu, which answer to the six pitch-pipes. The six pitch-pipes establish the yin and yang channels and join them to the twelve months, the twelve double-hours, the twelve joints, the twelve water-courses, the twelve hours and the twelve channels. This is how the five zang and six fu answer to the Way of Heaven. As for the twelve channels, they are that by which man lives and by which disease is formed, that by which man is cured and by which disease arises; they are where study begins and where the skilled physician stops. The coarse find them easy; the highest find them hard. I beg to ask how they separate, join, go out and come in.

Huang Di said: hearing this delights my ear but does not untie my heart. I beg you to finish it. Qi Bo replied: this is how man takes his place beside Heaven and Earth and answers to yin and yang; it must be examined. Foot taiyang corresponds outwardly to the clear water and inwardly belongs to the bladder, and it opens the water passage. Foot shaoyang corresponds to the Wei; foot yangming to the sea water; foot taiyin to the lake water; foot shaoyin to the Ru; foot jueyin to the Mian, each belonging inwardly to its zang — gallbladder, stomach, spleen, kidney and liver. Hand taiyang corresponds to the Huai and belongs to the small intestine, and the water passage comes out from it; hand shaoyang to the Luo and belongs to the triple burner; hand yangming to the Jiang and belongs to the large intestine; hand taiyin to the He and belongs to the lung; hand shaoyin to the Ji and belongs to the heart; hand xinzhu to the Zhang and belongs to the pericardium.

Thus when evil is in the receptacles the yang vessels are not harmonious; when the yang vessels are not harmonious the qi lingers; when the qi lingers the yang qi becomes excessive. When the yang qi is too abundant the yin is not benefited; when the yin vessels are not benefited the blood lingers; when the blood lingers the yin qi becomes excessive. When the yin qi is too abundant the yang qi cannot nourish it, and this is called the barrier. When the yang qi is too abundant the yin qi cannot nourish it, and this is called the obstruction. When yin and yang are both abundant and can neither nourish the other, this is called barrier and obstruction. In barrier and obstruction one cannot fulfil one’s term and dies.

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.

When evil is in spleen and stomach the flesh hurts. If yang qi is in excess and yin qi insufficient, there is heat in the middle and the patient is always hungry; if yang qi is insufficient and yin qi in excess, there is cold in the middle, rumbling and abdominal pain; if both are in excess, or both insufficient, there is both cold and heat, and all are harmonised at san li.

In jue bi the jue qi rises as far as the abdomen. Take the luo of yin and yang, look to which governs the disease, and drain the yang and tonify the yin channel.

On the third day of heat disease, if the qi mouth is quiet and renying is agitated, take all the yang channels with the fifty-nine prickings, to drain the heat and bring out sweat, and to fill the yin and tonify what is deficient. If the body is very hot and both yin and yang are quiet, do not needle. Where needling is possible, take it at once; if no sweat comes, the heat is still discharged. What is called not-to-be-needled has a sign of death.

The Emperor said: good. I have grasped its meaning and I have its practice as well. The nine needles are the principle of the channel’s compliance, and the disease of the yin and yang of the twelve channels.

The Yellow Emperor, at leisure, dismissed those about him and asked Qibo: I have heard the canon of the nine needles, and its discourse on the yin and yang, the reverse and the compliant, and the six channels is complete. I should like to receive what was transmitted by mouth.

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.

Qi Bo answered: One must first clearly know yin and yang, inner and outer, and where the xing and shu points lie; then the four seas are fixed.

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.

Qi Bo said: Guard qi in the body ordinarily runs beside the vessels through the interstices, moving with following and opposing, yin and yang attending one another, and so attains the harmony of heaven. The five zang take turns, the four seasons keep their order, and the five grains are transformed.

When yin and yang are not harmonious, the fluid overflows and runs down into the genital region; marrow and fluid are both diminished and descend, and when the descent is excessive there is deficiency, and the deficiency gives pain in the lower back and aching shins.

When the qi of yin and yang have just met and are not yet harmonised, and one drains them, both are lost and inner and outer separate; so the colour is lost and turns pale.

Qi Bo said: That is the yin and yang of heaven and earth, not the successive order of the four seasons and five phases. Moreover, yin and yang have names but no form; counted they may reach ten, divided they may reach a hundred, dispersed they may reach a thousand, extended they may reach ten thousand. That is what is meant.

The Emperor said: This is what is meant by keeping the one and not losing it, so that the ten thousand things are complete. I have now heard the essentials of yin and yang, the principle of vacuity and repletion, the fault of leaning and shifting, and the categories of what can be treated. I should like to hear the changes of disease, and the soaking transmission that ruins beyond cure. May I hear it?

Qi Bo said: When yin qi is abundant, one dreams of wading a great river and being afraid; when yang qi is abundant, of great fire burning; when both are abundant, of killing one another. When the upper is abundant, one dreams of flying; when the lower is abundant, of falling. When very hungry, one dreams of taking; when very full, of giving.

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?

The Emperor said: How profound! The brightness of the bright cannot be covered; it cannot be covered because it does not lose yin and yang. Join and examine it, press and verify it, see and obtain it, as clear water and a bright mirror do not lose the form.

The carpenter grinds his axe and adze, whets his knife, and cuts timber. Even in wood there is yin and yang, and there is hard and brittle. The hard does not admit the blade; the brittle sheds its bark; and at the joint, the axe is chipped.

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.

These are the regions of the five viscera, six fu, limbs and joints. Each has its part; having its part, use yin to harmonise yang and yang to harmonise yin. When the parts are clearly understood, ten thousand movements are ten thousand correct. To distinguish left and right is called the great way. Man and woman have different positions, hence yin and yang. To examine moisture and withering is what makes a good craftsman.

Shao Yu said: In the coward the eyes are large but not deep-set, yin and yang lose their correspondence, the texture of his burner runs lengthwise, the breastbone is short and small, the liver system is slack, the gallbladder is not full but hangs loose, stomach and intestines stand out, and beneath the ribs there is emptiness. Even in great anger his qi cannot fill his chest; though liver and lung rise, when the qi fails they sink again, and so he cannot be angry for long. This is what makes the coward.

The Yellow Emperor said: The five viscera store the essence-spirit and the ethereal and corporeal souls; the six palaces receive water and grain and transform them. Their qi within penetrates the five viscera and without connects the limbs and joints. The floating qi that does not follow the channels is the guarding qi; the refined qi that moves within the channels is the nutritive qi. Yin and yang follow one another, outside and inside run through one another like a ring without end, ceaselessly revolving — who can exhaust it?

The Yellow Emperor asked Bo Gao: I have heard that qi has its opposing and following, the pulse its fullness and decline, and needling its great rule. May I hear of them? Bo Gao said: The opposing and following of qi is what answers to heaven and earth, yin and yang, the four seasons and the five phases. The fullness and decline of the pulse is what discloses the vacuity or repletion, the excess or insufficiency of blood and qi. The great rule of needling is that one must know clearly whether the disease may be needled, whether it may not yet be needled, and whether it may no longer be needled.

The Emperor said: When disease arises, sometimes joy and anger are unregulated, food and drink are immoderate, yin qi is insufficient and yang qi excessive, and the nutritive qi does not move; then abscess and deep-seated sore break out. Yin and yang do not communicate, two heats strike together, and pus forms. Can the small needle remove that?

The Yellow Emperor said: Of the twelve channels, only the hand taiyin, the foot shaoyin, and the foot yangming move without rest. Why is that?

The Yellow Emperor said: I have heard of yin and yang people. What are they like?

Qi Bo said: One of much yang is much given to joy; one of much yin is much given to anger. One who is often angry is easily released, and so I say he has a good deal of yin. In him yin and yang are hard to separate and join, and therefore the spirit cannot go first.

Bo Gao said: Tonify what is insufficient, drain what is excessive, adjust the empty and the full, open its course and remove the evil. Give one dose of pinellia decoction; once yin and yang are open, sleep arrives at once.

The Yellow Emperor asked Shao Shi: I have heard that men have yin and yang — what is a yin man, and what is a yang man?

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.

Qi Bo said: Shaking off the dust is needling the outer channels to remove yang disease; opening the blind is needling the transport of the bowels to remove bowel disease; removing the claw is needling the joints and the network vessels of the limbs; piercing the garment is needling all the anomalous transports of the yang; dissolving bewilderment is knowing how to tune yin and yang and to tonify and drain excess and insufficiency, so that they lean from one to the other.

Hence when the night moves one lodge, man’s qi moves one circuit in the yin viscera and eight tenths of a viscus, just as the twenty-five circuits of the yang, and rejoins the eye. In a day and a night yin and yang together have a remainder of four tenths of the body and two tenths of the viscera; this is why men rise and lie down early or late — because the remainder is not exhausted.

Six is the pipes. The pipes tune yin and yang and the four seasons and join the twelve channels; when empty evil lodges in channels and network vessels it makes sudden obstruction. So for this needle one must make its tip like a yak’s hair, both round and sharp, with the body slightly large, to take sudden qi.

The eye is the essence of the five viscera and six bowels, the place where guarding and nutritive, animal soul and ethereal soul constantly operate, where spirit qi is born. Hence when the spirit is strained the souls scatter and the will is disordered. Therefore pupil and black of eye take law from yin, white and red vessels from yang, and yin and yang joined in transmission make the brightness. The eye is the heart’s envoy, and the heart is the spirit’s dwelling. Hence when spirit and essence are disordered and do not turn, and one suddenly sees what is not ordinary, spirit, essence and souls scatter and do not attain each other — this is called bewilderment.

The middle burner issues qi like dew; it pours up into the valleys and seeps into the grandson vessels; fluids are harmonised and transformed, turning red to become blood. When the blood is harmonious the grandson vessels first fill and overflow, then pour into the network vessels; when all are full they pour into the channels. Yin and yang being thus stretched, it moves with the breath, its movement has order, its circuit has a way, joining with heaven and unable to rest. Cut and tune it: from emptiness remove solidity; draining makes insufficiency; haste diminishes qi; retaining makes before and after; afterwards, from emptiness remove emptiness, and tonifying leaves excess. When blood and qi are tuned, form and qi hold.