Roots and Knots

Qi Bo said: Heaven and earth respond to each other, cold and warmth shift between each other. As for the pattern of yin and yang, which is less and which is more; the pattern of yin is even numbers, and the pattern of yang is odd numbers. When disease occurs in spring and summer, yin qi is little, yang qi is abundant, and yin and yang are not harmonized; how should one supplement and how should one drain? When disease occurs in autumn and winter, yang qi is little, yin qi is abundant; yin qi is exuberant while yang qi declines, so the stems and leaves of plants wither, rainwater flows downward and returns to the earth, yin and yang shift between each other; how should one drain and how should one supplement? Abnormal pathogenic qi departs from the channels; there are so many that they cannot be counted. If one does not know the roots and knots of the channels, the five viscera and six bowels, then the joints will be damaged, the pivots will be ruined, opening and closing will be disordered and essence qi will leak out, yin and yang will be greatly lost, and they cannot be restored. The mystery of the nine needles lies in their beginning and end; therefore, if one can know the principle of beginning and end, a single sentence can explain it completely; if one does not know the principle of beginning and end, the way of needling is entirely cut off.

The root of the foot taiyang bladder channel is at the Zhiyin point, and its knot is at the Mingmen. Mingmen refers to the eyes. The root of the foot yangming stomach channel is at the Lidui point, and its knot is at the Sangda. Sangda refers to the area of the clamped ear (the cheekbone beside the nose). The root of the foot shaoyang gallbladder channel is at the Qiaoyin point, and its knot is at the Window Cage. Window Cage refers to the ear.

The foot taiyang channel governs opening, the foot yangming channel governs closing, and the foot shaoyang channel governs the pivot. Therefore, if the function of opening is disordered, then the spaces between muscles and joints will become debilitated and sudden diseases will arise. Thus for sudden diseases, one should take the foot taiyang channel, observing its excess or deficiency. What is called "duct" refers to the skin and muscles being atrophied and weak. If the function of closing is disordered, then qi has no place to rest and atrophy diseases arise. Thus for atrophy diseases, one should take the foot yangming channel, observing its excess or deficiency. What is called "having no place to rest" means that genuine qi is and pathogenic qi is entrenched there. If the function of the pivot is disordered, then the bone joints will shake and cannot settle steadily on the ground. Thus for bone joint shaking, one should take the foot shaoyang channel, observing its excess or deficiency. What is called "bone swaying" means that the joints are loose and cannot be restrained. What is called "bone swaying" means shaking. One should seek its root.

The root of the foot taiyin spleen channel is at the Yinbai point, and its knot is at the Taicang (the Zhongwan point). The root of the foot shaoyin kidney channel is at the Yongquan point, and its knot is at the Lianquan point. The root of the foot jueyin liver channel is at the Dadun point, and its knot is at the Yuying (the Yutang point), and it networks at the Danzhong point.

The foot taiyin channel governs opening, the foot jueyin channel governs closing, and the foot shaoyin channel governs the pivot. Therefore, if the function of opening is disordered, then the granary (referring to the spleen and stomach) cannot transport and distribute, leading to diaphragm openness (blocked diaphragm qi and empty diarrhea). For diaphragm openness, one should take the foot taiyin channel, observing its excess or deficiency. Thus, when the function of opening is disordered, it is disease arising from qi deficiency. If the function of closing is disordered, then qi mechanism is severed and one easily becomes sorrowful. For sorrowfulness, one should take the foot jueyin channel, observing its excess or deficiency. If the function of the pivot is disordered, then vessel qi becomes knotted and stagnant, not flowing freely. For lack of free flow, one should take the foot shaoyin channel, observing its excess or deficiency. Where there is knotting, one should all take it to supplement the deficiency.

The root of the foot taiyang channel is at the Zhiyin point, it flows through the Jinggu point, pours into the Kunlun point, and ascends to enter the Tianzhu and Feiyang points. The root of the foot shaoyang channel is at the Qiaoyin point, it flows through the Qiuxu point, pours into the Yangfu point, and ascends to enter the Tianrong and Guangming points. The root of the foot yangming channel is at the Lidui point, it flows through the Chongyang point, pours into the Xialing (the Zusanli point), and ascends to enter the Renying and Fenglong points. The root of the hand taiyang channel is at the Shaoze point, it flows through the Yanggu point, pours into the Xiaohai point, and ascends to enter the Tianchuang and Zhizheng points. The root of the hand shaoyang channel is at the Guanchong point, it flows through the Yangchi point, pours into the Zhigou point, and ascends to enter the Tianyou and Waiguan points. The root of the hand yangming channel is at the Shangyang point, it flows through the Hegu point, pours into the Yangxi point, and ascends to enter the Futu and Pianli points. These are what are called the twelve channels; when the blood vessels are replete and full, one should all take these points.

A person circulates fifty cycles day and night, using them to transport the essence of the five viscera. If it does not match this number, it is called "wild life." What is called fifty cycles means that the five viscera all receive nourishment from qi. Examine the cunkou pulse and count its beating frequency. If there are fifty beats without a single pause, it means the five viscera all receive qi nourishment. If there is one pause within forty beats, it means one viscus lacks qi. If there is one pause within thirty beats, it means two viscera lack qi. If there is one pause within twenty beats, it means three viscera lack qi. If there is one pause within ten beats, it means four viscera lack qi. If there is a pause within less than ten beats, it means the five viscera all lack qi. One can predict their death period; the key lies in the principle of beginning and end. What is called having no pause within fifty beats is taken as the normal standard. Using it to understand the period of the five viscera and predict their death period refers to the pulse being sometimes fast and sometimes slow.

Huangdi said: Regarding the five types of inverse and smooth body constitution, it is said that people's bone joints vary in size, muscles vary in firmness and fragility, skin varies in thickness, blood varies in clarity and turbidity, qi movement varies in slipperiness and roughness, channels vary in length, blood varies in quantity, and the number of channel networks—I have already understood these, and they all refer to the common people. As for those dukes and high officials, lords who eat meat dishes, their bodies are tender and fragile, their muscles are soft, and their blood and qi are light and slippery. Can the slowness or speed, depth or shallowness, and amount of needling be the same as for the common people? Qi Bo replied: How can those who eat refined food and those who eat coarse grains be the same? Where qi is slippery, withdraw the needle quickly; where qi is rough, withdraw the needle slowly. Where qi is light, use a small needle and insert shallowly; where qi is rough, use a large needle and insert deeply. For deep needling, one wishes to retain the needle; for shallow needling, one wishes to withdraw the needle quickly. From this perspective, needling the common people requires deep insertion and retention of the needle; needling dukes and high officials requires light needling and slowness, all because their qi is light and slippery.

Huangdi said: What is meant by the inverse and smooth conditions of physical qi and disease qi? Qi Bo said: If physical qi is insufficient and disease qi is excessive, this indicates pathogenic qi is dominant; one should urgently use draining method. If physical qi is excessive and disease qi is insufficient, one should urgently use supplementing method. If physical qi is insufficient and disease qi is also insufficient, this indicates both yin and yang qi are insufficient; needling should not be used, as needling would make the deficiency more severe. Greater deficiency would cause both yin and yang to be exhausted, blood and qi to be completely depleted, the five viscera to be empty, and bones, sinews, and marrow to dry up. In the elderly, death results; in the robust, they cannot recover. If physical qi is excessive and disease qi is also excessive, this is called both yin and yang being excessive. One should urgently drain the pathogenic qi and harmonize its deficiency and excess. Thus it is said: For excess, use draining; for deficiency, use supplementing; this is the principle.

Thus it is said: If needling does not know inverse and smooth, it will cause righteous qi and pathogenic qi to struggle with each other. For a repletion pattern, if supplementing is used, it will cause yin and yang qi to disperse and overflow, the intestines and stomach to become distended and full, the liver and lungs to be internally distended, and yin and yang to be disordered. For a deficiency pattern, if draining is used, it will cause the channels to become empty, blood and qi to dry up, the intestines and stomach to become slack and weak, the skin to adhere to the bones, and the fine hair and interstices to wither; the death date can be determined. Thus it is said: The key to using needles lies in knowing how to harmonize yin and yang. Once yin and yang are harmonized, essence qi becomes bright and manifest, causing the physical body and qi to unite, and causing spirit qi to be stored within. Thus it is said: A superior physician can balance qi mechanism, an average physician will disorder the channels, and an inferior physician will sever qi mechanism and harm life. Thus it is said: The inferior physician must be cautious; one must carefully examine the diseases arising from the five viscera, the correspondence of the five visceral pulses, the deficiency and excess of the channels and networks, and the coarseness or fineness of the skin, and only then select points for needling.