Jade Tablet

The Yellow Emperor said: I originally thought the small needle was a tiny thing, yet you say it aligns with Heaven above, Earth below, and humanity in between. I believe this may be overstating the needle’s function, and I wish to hear the reasoning behind it. Qi Bo said: What thing is greater than Heaven? Among things larger than the needle, there are only the five weapons. The five weapons are used to guard against death, not as tools to save life. Moreover, humanity itself is the most settled existence between Heaven and Earth; how could it not reference Heaven and Earth? To govern the people, one can only rely on the needle. Then compared to the five weapons, which is smaller?

The Yellow Emperor said: When disease arises, there are cases of joy and anger without constancy, immoderate, insufficiency of yin qi, excess of yang qi, and stagnation of construction qi, which then develop into abscesses and carbuncles. When yin and yang are blocked, and two heats contend with each other, they transform into pus. Can the small needle treat this? Qi Bo said: A sage cannot cause an already formed disease to dissolve on its own; evil qi cannot be retained. Thus, when two armies confront each other, banners face each other, and naked blades are arrayed in the wilderness, this is not planned in a single day. To enable the people to obey orders and forbear, and for soldiers to escape the calamity of naked blades, this is not achieved in a single day of instruction, nor obtained in a single moment. As for causing the body to suffer abscess and carbuncle disease, with accumulation of pus and blood, is this not far from the Way? The onset of abscess and carbuncle, the formation of pus and blood, does not fall from Heaven nor well up from Earth; it arises from minute accumulations. Therefore, the sage regulates himself before disease forms, while the foolish suffer pain only after disease has already formed.

The Yellow Emperor said: When disease has already formed, there is no time to avoid it; when pus has already formed, there is no time to see it. What is to be done about this? Qi Bo said: When pus has already formed, ten die and one survives. Therefore, the sage does not allow it to form, but clearly formulates good prescriptions, records them on bamboo and silk, and has capable people follow and transmit them to later generations without end. This is to keep people from suffering illness. The Yellow Emperor said: After pus and blood have already formed and suffering ensues, is it not treated by guiding with the small needle? Qi Bo said: Using the small needle to treat small diseases, the effect is small; using the large needle to treat large diseases, the harm is great. Therefore, when pus and blood have already formed, only the stone needle, the lance needle, and the sharp needle are used to treat them.

The Yellow Emperor said: When harm is great, can it not be preserved? Qi Bo said: This lies in the favorable or unfavorable course of the disease. The Yellow Emperor said: I wish to hear about favorable and unfavorable courses. Qi Bo said: If the patient has an injury, the whites of the eyes turn blue, and the black of the eye becomes small, this is the first unfavorable sign. If vomiting occurs after taking medicine, this is the second unfavorable sign. If abdominal pain and severe thirst are present, this is the third unfavorable sign. If movement of the shoulder and neck is impaired, this is the fourth unfavorable sign. If the voice becomes hoarse and the complexion decays, this is the fifth unfavorable sign. If these five conditions are removed, then it is favorable.

The Yellow Emperor said: All diseases have favorable and unfavorable courses. May I hear about them? Qi Bo said: Distended abdomen, body heat, and a large pulse—this is the first unfavorable sign. Abdominal rumbling with distention, cold limbs, diarrhea, and a large pulse—this is the second unfavorable sign. Unceasing nosebleed with a large pulse—this is the third unfavorable sign. Coughing with blood in the urine, physical decay, and a small but forceful pulse—this is the fourth unfavorable sign. Coughing, physical decay, body heat, and a small, rapid pulse—this is the fifth unfavorable sign. In cases like these, death occurs within no more than fifteen days. Extreme abdominal distention, cold limbs, physical decay, and severe diarrhea—this is the first unfavorable sign. Abdominal distention with blood in the stool, a large pulse that occasionally ceases—this is the second unfavorable sign. Coughing with blood in the urine, decay of the physical and muscular form, and a pulse that strikes forcefully—this is the third unfavorable sign. Vomiting blood, chest fullness drawing to the back, and a small, rapid pulse—this is the fourth unfavorable sign. Coughing and vomiting, abdominal distention with diarrhea of undigested food, and a pulse that ceases—this is the fifth unfavorable sign. In cases like these, death occurs within no more than one hour. If the physician does not detect these conditions and needles, it is called contrary treatment.

The Yellow Emperor said: The needle method you describe is extremely subtle, matching Heaven and Earth, aligning above with celestial patterns, below with earthly principles, distinguishing internally the five viscera, and ordering externally the six bowels. The twenty-eight meetings of the channels all have their complete circulatory patterns. It can kill the living but cannot restore the dead to life. Can you change this? Qi Bo said: Truly, it can kill the living but cannot restore the dead to life. The Yellow Emperor said: When I hear this, I consider it inhumane, yet I still wish to hear the reasoning behind it, so as not to practice it on people. Qi Bo said: This is an obvious principle, a necessity. Just as a blade can kill a person, or drinking wine can make one drunk, even without examination, it can be known. The Yellow Emperor said: I wish to hear it thoroughly. Qi Bo said: Qi that humans receive comes from water and grain. The place where water and grain enter is the stomach. The stomach is the sea of water, grain, qi, and blood. The qi moved by this sea is like the clouds in the sky. The qi and blood output by the stomach pass through the channel passages. The channel passages are the great network channels of the five viscera and six bowels. Meeting them head-on and seizing their qi and blood can cause people to fall ill or die.

The Yellow Emperor said: Are the numbers of upper and lower acupoints fixed? Qi Bo said: To needle the Five Li point against its flow, the flow will be blocked midway. After five needlings, it is finished. After five comings and goings, the qi of the viscera is exhausted. Thus, five times five makes twenty-five, and the qi of the transport points is depleted. This is what is called seizing a person’s heavenly qi. Is this not sufficient to end a person’s life and shorten their allotted span? The Yellow Emperor said: I wish to hear it thoroughly. Qi Bo said: He who needles by peeping through the doorway causes the patient to die at home; he who enters the doorway to needle causes the patient to die in the hall. The Yellow Emperor said: Excellent, this medical method! Clear, this principle! Allow me to record it on a jade tablet, to treasure it as an important treasure, to transmit it to later generations as a prohibition for needling, so that the people dare not transgress it.