A Discourse on Puncture in Accord with and Contrary to the Four Seasons

Sì shí cì nì cóng lùn

Sixty-four is a short chapter with a long shadow: it is the one that asks what the seasons have to do with the needle, and answers by listing, one after another, the things that go wrong when the two disagree. It falls into four movements, and the first is a table. The table takes the six channels and gives each one four lines: what its surplus produces, what its insufficiency produces, and what a slippery or a rough pulse adds to either. Ceasing yin gives yin obstruction when full and heat obstruction when empty, fox mounting wind when the pulse is slippery and gathered qi in the lower abdomen when it is rough. Lesser yin gives skin obstruction and hidden rash; greater yin, flesh obstruction with cold in the centre; yang brightness, vessel obstruction with the body hot at times; greater yang, bone obstruction and a heavy body; lesser yang, sinew obstruction and fullness in the flanks. Then comes the part that has always puzzled the commentators: what is surplus in one channel is named after a viscus belonging to another — lesser yin after the lung, yang brightness after the heart — and 丹波元簡 simply observes that this chapter pairs the six channels with the five viscera in its own way, and that the received glosses which reach for the doctrine of the circuit qi are not to be followed. The second movement is the calendar, and it is the reason the chapter exists. In spring the qi is in the channels, in summer in the grandchild network, in late summer in the flesh, in autumn in the skin, in winter in the bone and marrow; and 歧伯 gives the grounds for each — spring opens the qi of heaven and discharges the qi of earth, so the ice melts and water runs and the channels open through; autumn draws in, the interstices shut, the skin pulls taut; winter covers and stores, and the blood and qi lodge inward in the marrow. Evil always enters by following the qi and blood of the season. Its transformations cannot be measured in advance, but it can always be met on the channel it has entered by. The third movement is the catalogue that gives the chapter its title: the twelve errors. Needle the network in spring and the blood spills outward, leaving a person short of qi; needle the flesh and the qi turns about in counterflow; needle the sinews and bone and it lodges inward, swelling the belly. Summer gives slackness and spentness, fear, anger; autumn gives forgetfulness, lying still, shivering; winter gives failing sight, a great obstruction left behind, forgetfulness again. 張介賓 notes that the text is lacunose — each season should have four entries and each has three, 春 missing its 經脉, 夏 its 絡脉, 秋 its 肌肉, 冬 its 筋骨 — and the gap is left as the base text has it. The closing lines are the chapter's rule in three sentences: needling that does not know the channels of the four seasons takes compliance for counterflow and disorders the correct qi until it presses against the essence; one must examine the nine probes. To that the text appends a short coda on striking the five viscera — heart, liver, lung, kidney, spleen, with the day of death and the sign each stirs. The passage is given again, almost word for word, in ch52; here alone the kidney's sign is 嚏欠 rather than 嚏 alone, which 張介賓 notes as the one addition.