Discussion of Blood Vessels

Huangdi said: I wish to hear you explain the circumstances of strange pathogens that are not within the channels. Qibo said: These are the blood collaterals (the fine vessels floating on the body surface).

Huangdi asked: When needling the blood collaterals, why do patients faint? When blood issues forth in a spurt, why is that? When the amount of blood is small, the color black and turbid, why is that? When the blood is thin and clear, half like water, why is that? After withdrawing the needle, why does local swelling occur? When more or less blood is released and the complexion becomes pale, why is that? After withdrawing the needle, the complexion does not change, yet there is vexation and oppression in the heart, why is that? When much blood is released, yet the body does not shake or waver, why is that? I wish to hear the reasons for all this.

Qibo said: In those with exuberant vessel qi but blood vacuity, needling will dissipate their qi; when qi is dissipated, they faint. In those with both blood and qi exuberant but yin qi predominant, their blood is slippery, so when needling, it spurts forth; when yang qi accumulates internally, stays for a long time and cannot be drained, the blood color is black and turbid, thus it cannot spurt. When one has just drunk water, the fluid seeps into the blood collaterals but has not yet fully blended with the blood, so when blood is released, there is thin, clear fluid separated out; if the person has not just drunk water, but there is originally water-dampness retained in the body, over time this will form swelling. When yin qi accumulates in the yang division, its qi stagnates in the collateral vessels, so when needling, the blood has not yet come out but the qi has already moved ahead, thus swelling occurs. When yin qi and yang qi have just intermingled but are not yet harmonized, and in this condition the draining method is used, it causes both yin and yang qi to be lost, and the interior and exterior separate from each other, so the face loses its blood color and becomes pale. When much blood is released with needling, the complexion does not change yet there is vexation and oppression in the heart, this is because needling the collateral causes channel qi to become deficient; when channel qi is deficient and it pertains to the yin aspect, yin qi is lost, so vexation and oppression occur. When yin and yang qi intermingle and congeal into a bi pattern (obstruction), this is because blood and qi overflow internally into the channels and externally pour into the collaterals. In such a condition, both yin and yang have excess; although much blood is released, it does not create deficiency.

Huangdi asked: How does one examine the blood collaterals? Qibo said: When the blood collaterals are replete, hard, transverse-oblique, and red in color, with no fixed position above or below, some as fine as a needle, some as coarse as a sinew, when such blood collaterals are seen, use the draining method to release blood—this is a sure and complete strategy, so do not violate this rule. If this rule is violated, then corresponding diseases will each arise.

Huangdi asked: After the needle is inserted, the needle body is tightly gripped by the muscle—why is that? Qibo said: When heat qi accumulates due to the needle, the needle becomes hot; when hot, the muscle adheres to the needle, so the needle body feels stiff and hard.