Form and qi · xing qi

“So where the form is weak and the qi deficient, there is death; where the form and qi are in excess but the pulse qi insufficient, there is death; where the pulse qi is in excess and the form and qi insufficient, there is life.”

To observe what is dark and obscure means this: that the form, the qi, the construction and the defence do not show themselves outwardly, and yet the physician alone knows them.

Qi Bo says: when a man is worn by labour, the qi of the body declines and grows scant and the qi of grain is not abundant; the upper burner does not move and the lower duct does not pass through. The stomach qi heats, the hot qi steams the chest, and there is heat within.

Knowing its coming and going means knowing the adverse and the favorable, the abundant and the deficient, of the qi. To keep an appointment with it means knowing the time when the qi may be taken. The coarseness of the coarse means that in the dark they do not know the subtle secrecy of the qi. Marvellous indeed, the workman alone has it means he fully knows the meaning of the needle. Those that go are adverse means the qi is deficient and small, and the small is adverse. Those that come are favorable means the form and qi are level, and the level is favorable. Clearly knowing the adverse and the favorable, walking straight without interval means knowing the place to be taken. To meet and seize it is reduction; to pursue and assist it is supplementation.

Huang Di said: The six changes of disease — how are they needled? Qi Bo answered: All that are urgent are mostly cold; the slow are mostly hot; the large have much qi and little blood; the small have little blood and qi; the slippery have abundant yang qi with slight heat; the rough have much blood and little qi with slight cold. Therefore for the urgent, insert deeply and retain long; for the slow, insert shallowly and withdraw the needle quickly to remove the heat; for the large, slightly reduce the qi and do not let blood out; for the slippery, withdraw the needle quickly while inserting shallowly, to reduce the yang qi and remove the heat; for the rough, one must hit the vessel and retain the needle long according to its adverse or favorable course. One must first press and follow it, and when the needle is withdrawn press the hole quickly, not letting the blood come out, so as to harmonise the vessel. As for all the small, yin and yang, form and qi are all insufficient: do not take them with the needle, but regulate them with sweet medicine.

Huang Di said: What is the adverse and favorable of form and qi?

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?

In the method of needling one must examine the patient’s form and qi. Where the form and flesh are not yet wasted, where qi is scant and the pulse is agitated, and the agitation amounts to reversal, one must use contralateral needling. Scattered qi can be gathered, gathered qi can be spread. Dwell deep and still, reckon the coming and going of the spirit, shut the door and stop the window, so that hun and po do not scatter. Single the mind and unify the spirit, distinguish the essence and qi, let no human voice be heard, so as to gather the essence; unify the spirit and set the will upon the needle.

The Emperor said: You have spoken of the above and below of the pulse and the signs of blood and qi by which one knows form and qi. How is it done?

Qi Bo said: The reversal of qi, and the worsening of the disease with repeated insertions, are not a matter of yin and yang qi or of floating and sinking tendency. These are all the failures of the coarse workman and the losses of the superior one; the form and qi of the patient are not at fault.

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.

Pray let me speak of the discourse of untying: it answers to heaven and earth, accords with the four seasons; man takes part in heaven and earth, and so there can be untying. Where below there is marshy ground, above grow reeds and rushes — by this one knows how much form and qi there are.

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.