68416942-lingshu (1)

Nguyen Van Nghi Tran Viet Dzung Christine Recours Nguyen

huangdi neijing LINGSHU

Volume III Books VI - IX N.V.N. Edition Translated from the French by Edward S. Garbacz, MD With Additional Commentary by Sean Christiaan Marshall, D. Ac. © Jung Tao School of Classical Chinese Medicine - 2002 9.

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Preface

In this manner is Volume III of the Lingshu ended which finally completes the study of this monumental basic work of Classical Chinese Medicine! We experience at the same time a feeling of pride and relief because this was a work of extremely arduous translation, comprehension and analysis which had demanded of us more than 10 years of labor. This reference work delivers to us a little bit of truth, of very involved and complex facts, which made it necessary for us to continuously decipher, replace and transpose the information in order to make it accessible to every acupunturist. Like the two previous volumes, we have developed commentaries because, handed over in a crude state, this book is nearly incomprehensible. Thanks to the expert interpretive work by the most reputable commentators over the centuries, and more modestly by ourselves, one achieves clarification and restoration√: _ in order not to be totally mistaken in seeing only a primitive medicine that’s without interest _ in order to better comprehend CCM (Classical Chinese Medicine), to deeply delve into all its facts without arbitrarily neglecting some (as in our present time, for example, the luo vessels and curious channels) _ and in order to envision WM (Western Medicine) from another perspective, different, but complementary and enriching. Concerning this point of view, the Lingshu offers us the possibility of drawing from it numerous ideas of modernity. We can cite the most obvious examples: 1. There is a postulate that has become recently universal: “Energy creates matter”. Now that expresses differently the famous phrase: “Qi forms Xing” found in the Lingshu. It is in this manner that these two notions, the first arising from modern science, the second from CCM, as a result of geographic, chronologic and intellectual extremes, in the end express the same idea. For the Western world, this postulate came from observation of physical phenomena from the second part of the 20th century, but this notion concerns more particularly the physicochemical rather than medical field, and it remains still quite neglected in the field of WM, in accordance with Cartesian medical reasoning. For CCM, whose reasoning originates from a specific thought process of the Oriental mind and is applicable to every field, not just medical, this postulate has been known since the dawn of time. Therefore, we learn in the Lingshu that every change in matter always comes from a change in the state of the energy.

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2. Another very modern trend is the development of immunology in WM. A large part of the Lingshu is devoted to the Wei Energy. Wei, defensive energy, plays a similar role to known immunologic processes because, like innate, non-specific immunity, it permits struggle against pathogenic agent introduced within the organism. It is then possible to establish a correlation between Wei energy and immune defense. Immunodficiency, otherwise known as Emptiness of Wei, is, in WM and CCM, at the core of all diseases. It is said in the Lingshu: “Wei energy defends us and kills us.” 10.

3. In the Lingshu is also found a mode of reasoning that is only discovered these days in WM and which paradoxically considerably modernizes it. For example: _ the notion of “cycle”, a fundamental concept in CCM, which begins to be known in WM (Krebs cycle, cardiac cycle, menstrual cycle...), _ the notion of “chain” with stimulation, synthesis and inhibition (hormonal secretion, muscular movement, glycemia, blood volume...), _ the notion of environmental or behavioral factors (ethologic, psycho-social), _ the notion of “gate” or “door” (gate control in pain physiology, “gate” in the regulation of cellular membrane permeability to ions, for example). These ultra-modern ideas of cycle, chain, chronobiology, and still others, are therefore contained in the three thousand years old Lingshu, as well as clinical examples (like the formation of tumors) which can permit improving its practice as much as in CCM as in WM. To anyone going to the trouble of delving deeply into the information contained in this bible of Chinese medicine, they are furnished knowledge applicable to modern medicine. We achieve then a novel enlightenment about pathologic processes as observed in a fundamentally different manner from present scientists. On the one hand, one notices the change in matter without, however, managing to explain it, and, on the other hand, in the aid of scientific examinations, one better recognizes the envisioned pathologic state as soon as it appears and treats it at the level of the energy. If one can, therefore, apply certain knowledge from CCM to WM; inversely, it is just as easily understood possible to apply certain knowledge from WM to CCM. But to do so systematically, without mutual exchange, in accordance with the preponderance of WM, risking over-Westernizing acupuncture. Via too much desire to conform to scienticism, CCM will lose its identity and its natural essence. In this way, we observe that the present tendency, both in China and Vietnam, is especially to develop phytotherapy or points of acupuncture via some sort of “recipe”. This course is dedictated to failure because the extreme energetic variability of the individual is barely taken into account. One consequently only attaches importance to the simplistic basis of MTC, a phenomenon not only dictated by medical misjudgment, but especially by the profit motive of commerce and economic demands. As a result, fundamental investigations are neglected for profit of gain and immediate results. But true Acupuncture comes from the Lingshu and other magistral works, sources of

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pathophysiology and therapy in CCM. It is only by reading and analysis that one will attain the development of CCM and tend toward mastery of the disease process. We hope that the accomplishment of this stake in the form of the Lingshu will provide the practicing physician and scientist every benefit expected for themselves and the patient. We envision the time which will see the fusion of the modes of thought, of these two medicines, succeeding to bring forth one universal medicine. Then we will have not labored in vain.

Marseille, October 10, 1998 Dr. Nguyen Van Nghi

11.

Book VI Book VI consists of 10 chapters:

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Chapter 49 : The Five Colors (Wu Zu) Chapter 50 : Discussion on Courage (Lun Zung) Chapter 51 : Shu of the Back (Bei Shu) Chapter 52 : Defensive Energy (Wei Qi) Chapter 53 : Discussion on Pain (Lun Tong) Chapter 54 : Celestial Age (Tian Nian) Chapter 55 : Contrary and Favorable (Xi Zuan) Chapter 56 : The Five Sapors (Wu Wei)

12.

Chapter 57 : Hydropsy (Shui Zhang) Chapter 58 : Pirate Wind (Zi Feng) 13.

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CHAPTER XLIX The Five Colors (Wu Za)

Chapter 49 of the Lingshu speaks on the reflection of the energetic state of the 5 organs and 6 bowels at the level of the face in the form of “5 Colors” of clearly defined localization. The areas or reflection of the 5 organs are gathered together at the forehead and nose, and those of the 6 bowels, at the two cheeks. According to changes of the color of the face, one can diagnose diseases of the organs and bowels, and according to the light or dark, diffuse or concentrated, shiny or dull, moist or dry coloration, one can judge the superficial or deep localization of the disease, its acute or chronic state and its good or poor prognosis. The objective of this chapter is the study of the 5 Colors (green, red, yellow, white and black) as a function of the 5 organs in order to establish a basis of diagnosis. This is why it is entitled: “The Five Colors” (Wu Za). This chapter consists of 16 paragraphs.

PARAGRAPH 1 Leigong questions Huangdi: “Are the five colors only determined at Mingtang?

I still do not understand.”

Huangdi: “ Mingtang designates the nose. Jue, the inter-eyeborw space Ding, the forehead and its two sides Fan, the two sides of the crest of the nose Ti, the front of the acoustic meatus. These different regions must be even and large, visible beyond

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14.

10 paces, and man can live to 100 years.” EXPLANATIONS AND COMMENTARIES I - Ma Shi describes:

“The phrase “The 5 colors are all determined at Mingtang” is mentioned in Chapter 37 of this classic (“5 Approvals and 5 Emissaries”). Leigong brings it back up to question Huangdi.” II - N.V.N.: Recall (1), the 5 facial areas (Wu Guan) can be diagrammed in the following fashion:

1. See Lingshu, Volume II, Chapter 37, p. 220, diagram 65.

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Figure 1 The five facial areas (Wu Guan)

PARAGRAPH 2

15.

Leigong: “How do you discern Wu Guan (5 facial areas)?” Huangdi: “The bone of Mingtang (nose) is prominent and raised, flat and straight. Its center represents the 5 organs, and its 2 sides, the 6 bowels.

Jue (inter-eyebrow space) and Ding (forehead) are at the top of the face, and the “royal palace” is found between the 2 eyes. The 5 organs in the thorax and abdomen, at peace, reflect their true colors. M i n g t a n g , not presenting pathologic color, is pure, smooth and brilliant. How then could you not be able to discern Wu Guan ? ”

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EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains:

“1 - Wu Guan (Five Barriers or areas of reflection of the energy of the 5 organs) (2) are the sites of manifestation of the Jing (quintessence) of the 5 organs and 6 bowels. Mingtang designates the nose. The bone of the prominent nose, well-raised and straight, reproduces the order of placement of the 5 organs located in the interior. The area located between Jue (inter-eyebrow space) and Ding (middle of the forehead) responds to the lung. Underneath Jue, at the base of the nose between the two eyes, responds to the heart. The middle of the crest of the nose, at the highest point, responds to the liver. Further below, at the tip of the nose, responds to the spleen. The 5 organs are Yin and govern the interior. The localization of their reflected energy therefore follows the order of their established sites in the interior. 2 _ _ _ _ _

- The energy of the 6 bowels becomes exteriorized at the two sides of the nose: the gallbladder, at the 2 sides of the liver the stomach, at the 2 sides of the spleen the large intestine, outside the nasal ala, on the cheek the small intestine, at the 2 sides of the nose, in the middle of the cheek the bladder and uterus, at the 2 sides and outside the naso-labial groove, under the nostrils. The bowels are Yang and govern the exterior. This is why their reflected energy is located outside the nose.

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The kidney is the Water-Organ. As a result, it follows the large intestine and lies near the edge (contour) of the face, in order to respond to the center where Spleen-Earth is found. Therefore, the middle of the face responds to Earth which is surrounded with water. 3 - Tian Jue (“Celestial” inter-eyebrow space) is above and Wang Gong (royal palace) is down below. This notion gives evidence of the presence of the three units “Heaven-Earth-Man 2. According to the context, Wu Guan do not designate the 5 sense organs, but the areas of observation of the face. There is then often confusion in translation into Western language.

of the face” (3). Jue/Ding belongs to the lung because the lung responds to Heaven; the spleen is located down below because the spleen responds to Earth (low). 4 - When the 5 organs are at peace within the thorax and abdomen, their true color manifests at the exterior, at the nose, which is pure and smooth. Then why does one say that one cannot discern Wu Guan?”

III - N.V.N.: The areas of reflection of the 5 organs and 6 bowels are recalled in the following figure:

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Figure 2 Areas of reflection of the energy of the 5 organs/6 bowels.

3. See Chapter 37 (“5 Approvals and 5 Emissaries”), Volume II of the Lingshu.

PARAGRAPH 3

17.

Leigong: “Your young disciple would like to hear you on the case where the distinction of the colors of different areas of observation (Wu Guan) is sometimes difficult.” Huangdi: “The 5 colors each have a reflected area. If this area is depressed to the bone, the disease is hardly curable. If the color of this area originates from the phenomenon of succession (Sheng Shi) of the 5 Movements (Mother-Son), despite the seriousness of the disease, the prognosis is not fatal.” EXPLANATIONS AND COMMENTARIES

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I - Zhang Shi explains:

“The term “distinction of color” implies only the distinction of pathologic colors and not the distinction of the “source-colors” (true color, physiologic color). Here, the “phenomenon of succession” (Sheng Shi), designating the “Mother-Son” chains of the law of the 5 Movements, are: _ appearance of yellow color in the heart area _ appearance of red color in the liver area _ appearance of the green color in the kidney area _ appearance of the black color in the lung area, etc.”

II - Ma Shi adds:

“Huangdi describes that the colors of Wu Guan (5 areas of observation) are examinable. For this reason, if one of these areas is depressed against the bone, the corresponding organ is, in a certain way, affected. In certain non-depressed areas, the presence of the color coming from the phenomena of succession (Sheng Shi) is the indicator of a favorable prognosis, despite the seriousness of the disease.”

III - N.V.N.:

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In practice, in diseases originating from the “mother-son” chains of the 5 Movements, treatment by Acupuncture/Moxabustion is generally recommended. In contrast, in diseases originating from other chains, the prescription of Oriental or Western medicines, associated with Acupuncture/Moxabustion, is always indicated.

PARAGRAPH 4 Leigong: “What are the corresponding signs of the colors of Wu Huangdi: “Green and black respond to pain. Yellow and red respond to heat (fever). White indicates cold (sensitivity to cold,

Guan ? ”

chills).

Such are the signs responding to the colors of Wu

Guan . ”

EXPLANATIONS AND COMMENTARIES I - Ma Shi explains: “This paragraph concerns the colors of Wu Guan whose appearance at a specific area permits defining the origin of the disease, In this manner: _ green and black belong to Feng-Han (Wind-Cold), causal factor of pain

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_ yellow and red belong to Earth-Fire (Humidity-Heat), causal factor in fever _ white belongs to the “Cold” energy, causal factor in sensitivity to cold and chills. Such are the basic natures of the colors caused by perverse energy coming from the exterior.” II - N.V.N.: The previous paragraph is devoted to the 5 pathologic colors of the 5 organs. Therefore, these colors are of endogenous origin. This paragraph concerns the colors of exogenous origin, that is to say, caused by cosmic perverse energy.

PARAGRAPH 5 Leigong: “How do you diagnose the worsening or improvement of disease?” Huangdi: “Examination

19.

of

the

interior

and

exterior

is

indispensable.

_ Mai Kou slippery (Hua), small (Wei), hurried (Jin) and deep (Chen) indicates worsening of the disease localizing in the interior, and Renying changing (Da), hurried (Jin) and superficial (Fu) , worsening of the disease localizing at the exterior. _ Mai Kou superficial (Fu) and slippery (Hua) indicates the progression of the disease, and Renying deep and s l i p p e r y , the regression of the disease. _ Mai Kou slippery and deep indicate the progressive worsening of the disease localizing in the interior, and Renying slippery, full and superficial, the progressive worsening of the disease at the exterior. Renying and Qi Kou having the same natures, superficial small or large, indicates the disease is difficult to treat.

or

deep,

In diseases of the organs, the deep (Chen) and changing (Da) pulse indicates the disease is easy to treat. In contrast, the small (Wei) pulse is unfavorable. In diseases of the bowel, the superficial (Fu) and changing (Da) pulse also indicates the disease is easy to treat. Renying full and resistant indicates the ailment caused by cold, and Qi Kou full and resistant, the ailment caused by digestive disorder.” EXPLANATIONS AND COMMENTARIES I - Ma Shi explains:

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“This paragraph discourses on the benignness and seriousness of disease localizing in the interior and at the exterior whose diagnosis must be made at the level of Mai Kou and Renying. Here, it concerns a reply from Huangdi to Leigong regarding the determination of the worsening and improvement of the disease. 1 - Renying governs the exterior, and Mai Kou governs the interior. For this reason, the slippery, small, hurried and deep Mai Kou is the indicator of worsening of the disease localizing in the interior, and the changing Renying following a hurried and superficial character indicates worsening of the disease localizing at the exterior. But Mai Kou without being slippery, small, hurried and deep can otherwise indicate the phase of worsening of the disease. The slippery quality followed by a superficial (instead of deep) quality also indicates this phase. Similarly, the changing Renying followed by a hurried and superficial character is not sufficient to indicate the accentuation of the disease. If it is deep and is followed by a slippery quality, it is the indicator of the improvement of the disease. 20. As a result, _ the hurried and superficial pulse followed by a slippery quality is the indicator of the worsening of the disease. _ the slippery nature followed by a deep quality indicates the worsening of the disease localizing in the interior; this is as if one said: “1 time, 2 times, 3 times fullness... of diseases belonging to the 6 Yin Channels of the 5 organs.”

2 - If Renying is deep, followed by a slippery quality, it indicates the improvement of the disease. If it is full and superficial, it denotes the worsening of the disease localizing at the exterior, as if one were to say: “1 time, 2 times, 3 times fullness of the diseases belonging to the 6 Yang channels of the 6 bowels.” On the other hand, during examination, if Renying and Mai Kou possess the same changing and small quality, it is the indicator of non-improvement of the external signs and internal signs. a - But in diseases of the 6 Yin channels belonging to the 5 organs, if the pulse is deep and changing, the disease is easy to treat because: _ the deep quality designates the disease localizing in the interior _ and the changing quality denotes the potential force of the vital energy. In contrast, if the deep pulse is followed by a small quality, it indicates the non-cure of the disease of the organ. b - The diseases of the 6 Yang channels are called “diseases of the 6 bowels”. In that case, the superficial and changing pulse is the indicator of rapid cure of the disease because: _ the superficial quality indicates the disease localizing at the exterior _ and the changing quality denotes the easy dispersion of the perverse energy. 3 - What is the criterion for determination of disease of external origin at Renying? The full and resistant pulse. It is a matter then of an ailment caused by “Cold” energy. What is the criterion for determination of disease of internal origin at Cun Kou? The full and resistant pulse. It is a matter then of an ailment caused by a digestive disorder.”

III - N.V.N.: The explanation of Zhang Jing Yue (1563-1640 A.D.) is very explicit and rich. We present below the complete translation of the commentary of this grand master:

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“1 - Mai Kou is the pulse belonging to the Taiyin. As a result, one says that it governs the center. In the interior, it maintains the 5 organs. 21. Renying is the pulse belonging to the Yangming. As a result, one says that it governs the exterior. At the exterior, it maintains the 6 bowels. The slippery, small, hurried and deep Mai Kou is due to the presence of perverse energy in complete fullness within the Yin area. The changing, hurried and superficial Renying is due to the presence of perverse energy in complete fullness within the Yang area. In these two cases, the disease is found in the phase of improvement. 2 - Mai Kou responds to Yin. When it is superficial and slippery, Yang flows out into Yin. This is why the disease worsens. Renying responds to Yang. When it is deep and slippery, it is the period of escape of the perverse energy. This is why the disease improves. Mai Kou and Renying have the same Yin and Yang natures as the channels. This is why they are divided into Biao (exterior) and Li (interior). Their deep and slippery or superficial and slippery natures are the distinctive phenomena of worsening of the disease localizing within the interior or at the exterior. 3 - The same qualities, superficial and deep, large and small noted at the same time at Renying and Mai Kou -- they are not oriented toward Yin, they are not oriented toward Yang, and vice versa -- are the indexes of the difficult-to-treat disease. _ “Diseases localizing within the organs” means: they are found at the 6 Yin channels and the Yin pulse must be deep. If it is deep and changing, it is because it is supplied/provided with Shen (mental). To have Shen is to have Yin Qi (Yin energy) in a plethoric state. This is why the disease is easy to treat. As for the deep, galloping and small pulse, it denotes the exhaustion of the Yin Root, an unfavorable factor, hence the difficulty in treating. _ “Diseases localizing in the bowels” indicates: they are found at the 6 Yang channels. In the Yang diseases, the Yang pulse is favorable. As a result, the superficial and changing pulse is the indicator of the disease that is easy to cure. In contrast, the superficial and small pulse is unfavorable, that is to say, the disease is difficult to cure. 4 - Here, it concerns a technique of antiquity. From the time of Wang Shu He (210-285 A.D.) to our times, examination of the pulse is performed at the level of the 2 Cun Kou (mouth of 1 cun; radial gutter): the one at the left has the name Renying, and the one at the right, the name Qi Kou (Mai Kou)”. (4)

PARAGRAPH 6

22.

Leigong: “How do you diagnose the seriousness and benignness of the disease according to the method of the colors?” Huangdi: “The bright color indicates the benignness of the disease, and the dark color, the seriousness of the disease. Displacement of the color toward the top reveals the worsening of the disease, and displacement toward the bottom, calling to mind the dispersion of clouds, indicates improvement in the disease.

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The 5 colors each have an organ-area, internal or external area. Displacement of the color from the external area toward the internal area indicates the progression of the disease from the exterior toward the interior; and displacement of the color from the internal area toward the external area indicates the progression of the disease from the interior toward the exterior. In diseases manifesting in the interior, treat first Yin, then Yang. The opposite worsens the disease. In diseases manifesting at the exterior, treat first Yang, then Yin. The opposite worsens the disease.”

EXPLANATIONS AND COMMENTARIES Ma Shi explains:

“This paragraph speaks on the diagnosis of seriousness and benignness of disease according to the method of examination of the colors. 1 - The light color responds to Yang. The dark color, to Yin. Yin and Yang are jointly visible. This is why one says: the disease worsens. 4. In this regard, see our explanations in the different chapters of the Lingshu, Nanjing and Maijing (N.V.N. Editions).

The 5 colors originate from the 5 organs and 5 Movements. They carry out movements from the interior toward the exterior and from below upwards in order to manifest at the face. Movements toward the top is the indicator of disease of Yang energy in a state of fullness, hence worsening of the disease. The energy of Earth ascends to form clouds. During the encounter with the energy of Heaven, the clouds dissipate. This dissipation is comparable to the cure of the disease. 2 - The “organ-areas” are the facial zones where the energy of the organs and bowels are reflected. Those belonging to the organs are at the center (of the face, nose), called “internal areas”, and those belonging to the bowels are at the exterior, called “external areas”. 23. The colors progressing from the external area toward the internal area originate from disease of exogenous origin, and those progressing from the internal area toward the external area originate from disease of endogenous origin. 3 - The bowel is Yang; it governs the exterior. The organ is Yin; it governs the interior. This is why: _ in diseases of internal origin, one must first treat Yin, then Yang; if not, the disease worsens. _ in diseases of external origin, one must first treat Yang, then Yin; if not, the disease deteriorates.”

PARAGRAPH 7 Leigong: “If the pulse is slippery and large, changing and long, it is the sign revealing disease coming from the exterior.

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In this case, if the eyes have the impression of seeing something and the Chi (will) appears to become that of hatred, this is due to a gathering of Yang energy that one can modify to favor cure.”

EXPLANATIONS AND COMMENTARIES Zhang Shi explains:

“The previous paragraph discourses on Yin and Yang, interior and exterior, that is to say, on diseases of the energy. In this manner, the pulsologic reactions manifest at Qi Kou (mouths of the energy) and the colors appear at Mingtang (nose). This paragraph completes the prevous one and involves disease at the energetic layer contaminating the Xue-Mai (Blood and Vessels) system because, when the energy (perverse) affluxes toward the blood, reactive phenomena manifest at the level of the “Three Departments” (“inch”, “barrier” and “foot”: Cun, Guan and Chi). These reactive phenomena are illustrated by the fllowing pulsologic qualities: _ slippery, symbol of Water-Cold _ large, symbol of Heat-Fire _ changing, symbol of Earth-Humidity 24. _ long, symbol of Wood-Wind. The pulse of slippery and large, changing and long nature reveals then disease coming from the exterior. The phrase “The eyes have the impression of seeing something” implies the sense of vision of colors (complexions). The phrase “The Chi (will) appears to become that of hatred” implies the sense of disturbances of the Shen (mental) of the 5 organs. Here, it concerns a case of gathering of Yang energy that one can modify to favor cure, that is to say, that it is necessary to first treat the exterior (to evacuate the perverse energy), then the interior (in order to tonify the essential energy).”

PARAGRAPH 8 Leigong: “Your young disciple has often heard you say that Feng (Wind) is the origin of the “100 Diseases” and that Jue Ni (contrary afflux) originates from cold and humidity. How do you distinguish them?” Huangdi: “One must examine the middle of Jue (inter-eyebrow space). If it is sparkling, it concerns Feng (Wind). If it is somber, it concerns Bi (obstruction, algoparesthesia). If the color appears at the “earth” (chin) region, the disease is Jue Ni (contrary afflux). Thus, it suffices to base one’s judgment on the variation of the color and on its localization in order to determine the disease.”

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EXPLANATIONS AND COMMENTARIES I - Ma Shi explains:

“In a general fashion, in order to make the distinction between Feng (wind) and Bi (obstruction), it is necessary to examine Jue Zhong (middle of the inter-eyebrow space). The bright and shimmering color is the indicator of attack of Feng (wind). The somber and dull color belongs to the Bi disease (obstruction = algoparesthesia). In contrast, the appearance of the color at the region mentioned is the sign revealing Jue Ni (contrary afflux) disease. It manifests first at the channels of the foot, then it affluxes toward the top. These colors are generally visible and easy to recognize. • As for the determination of the pathological zones of the 5 organs at the level of the face, one must distinguish: _ the green color of the liver 25. _ the red color of the heart _ the yellow color of the spleen _ the white color of the lung _ the black color of the kidney in order to differentiate the diseases of Feng (Wind), Bi (obstruction) and Jue Ni (contrary afflux) of the 5 organs.” II - N.V.N.: Zhang Jing Yue makes the following clarifications: “Disease of Wind is located at Yang, at the pilocutaneous system. This is why the color of this place is bright pale. Disease of Bi is located at Yin, at the musculo-skeletal system. This is why the color is somber and deep. Disease of Jue Ni starts at the 4 limbs. Since the disease is down below, the color appears at the “earth” zone, that is to say, at the lowest of the face (chin area). The appearance of these colors follows the usual rule, thanks to which one can diagnose diseases with precision.”

PARAGRAPH 9 Leigong: “Death can unexpectedly arise suddenly in persons appearing to be in good health. How can one know it?” Huangdi: “Da Qi (preverse energy of great virulence) directly attacking the organs and bowels can cause sudden death.” Leigong: “Despite improvement of the disease, one can also die suddenly. How do you prevent it?” Huangdi: “When red color appearing at the two cheeks is large like the great toe, death can arise suddenly despite a slight amelioration of the disease. When black color appearing at Tian Ding (forehead) is large like the great

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toe, death can also suddenly arise despite the absence of disease.”

EXPLANATIONS AND COMMENTARIES

26.

I - Zhang Shi explains:

“ This paragrah completes the previous one and speaks on diseases of exogenous and endogenous etiology. 1 - The violent and direct infiltration of perverse energy into the organs and bowels is the cause of sudden death. To speak of “persons apearing in good health” is to speak of individuals not presenting any pathologic signs, but susceptible to being attacked suddenly by perverse energy of great virulence (Da Qi). To speak of “sudden death despite a slight improvement of the disease” is to speak of sudden death following a disease of internal origin resulting from a phenomenon of reciprocal encroachment of the organs and bowels. The appearance of red color at the two cheeks and of black color at the forehead (Tian Ding) are reactive phenomena of the heart in a pathologic state favoring the phenomena of encroachment of the kidney on the heart because: _ red color responds to Fire _ and black color, to Water. The “slight improvement of the disease” is due to a phenomenon of delay of Water on Fire, and “sudden death” originates from the phenomenon of excessive inhibition of Water on Fire. 2 - When the disease is found within the energetic layer, the color is diffuse, and when it is found at the level of the vessels (channels), the color is limited and brief. “... large like the great toe” implies a strong concentration of color. The vessel-channel of the kidney emits a branch which penetrates into the thorax and reaches the heart, constituting the “Kidney-Heart” system. As a result, _ the appearance of red color at the two cheeks is the sign revealing the encroachment of the kidney on the non-ill heart. In this case, it is the energy of Heart-Fire which exteriorizes at the face in the form of red color. _ the appearance of black color at Tian Ding (forehead) comes from the encroachment of the kidney on the ill heart. In that case, the energy of Kidney-Water replaces that of Heart-Fire to manifest at the face in the form of black color. The 5 colors of the face are therefore manifestations of the source energy of the 5 organs at the exterior, during movements of reciprocal encroahchment propelled by the 5 Movements.”

II - N.V.N.: 27.

The words “Da Qi” designate perverse energy of great virulence. This Da Qi infiltrates into the organism only if the source energy of our bodies is in great insufficiency. The two colors (red and black) mentioned are grave signs, but black is the most worrisome. Zhang Jing Yue clarifies in this regard: “The appearance of the color of Water (black) at the area belonging to Fire and the appearance of the color of Fire (red) in the area belonging to Metal are due to the consequence of a great insufficiency of essential energy (source energy). The color the size of the great toe is extremely serious. Therefore, _ red color at the cheeks (responding to the shoulders which also govern the lung) reveals the encroachment of Fire on Metal. In this case, death can arise suddenly, even in the presence of signs of

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improvement of the disease. _ black color at Tian Ding (“celestial” part of the forehead: the uppermost part) originates from the exhaustion of the energgy of the kidney. In that case, death can arise suddenly, without apparent disease.”

PARAGRAPH 10 Leigong, bowing his head again, says: “That’s right! Do periods of determination of death exist?” Huandi: “By examination of the colors, one can determine the periods of death.” Leigong: “That’s correct! Your young disciple would like you to explain this to him in detail.” Huangdi: “ Ding (forehead) responds to the face and head.

Jue Shang (above pharyngeal system.

the

inter-eyebrow

space) responds to the laryngo-

Jue Zhong (middle of the inter-eyebrow space) represents the lung. Xia Gu (base of the nose) responds to the heart. Zhu Xia (crest of the nose) respresents

the

The left of Zhu Xia corresponds

gallbladder.

to

the

liver.

28.

Mian Wang (tip of the nose) responds to the spleen. Fang Shang (nasal ala) represents

the

stomach.

Zhong Yan (middle of the cheek) represents the large intestine which sticks close to the kidney whose center represents the umbilicus. Above the two sides of Mian Wang represent the small intestine, and below it, the bladder and uterus.

Quan (cheekbone: zygomatic bone) represents the shoulder. Behind the shoulder is the arm, and behind the arm is the forearm and hand. Above the internal canthus of the eye represents the thorax and breasts. The area near the ear, oriented toward the top, represents the back. Below the maxilla is located the thigh, and at the center, that is to say, between the top and bottom of the jaw, the knee. The area under the knee responds to the leg, and that which is found on the other side of the leg, the foot.

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Gua

Ju Fen (labial commisure) responds to the internal surface of the thigh; Ju (great curvature) , to the zygomatic bone, and Xi Xin (knee bone), to the patella.

Such are the facial zones responding to the 5 organs, 6 bowels and joints of the limbs. The determination of these areas facilitates the utilization of Yin to harmonize Yang and the utilization of Yang to harmonize Yin. To delve deeply into these different areas is to “practice 1000 and succeed at 1 0 0 0 ” . If one can still distinguish the movements oriented toward the left or toward the right, it is to understand the Da Dao (Great Principle) of Yin and Yang because the appearance of the color at the level of these areas is different in young boys and young girls. This is why one names them “routes of orientation of the Yin movement and Yang movement”. On examination, the discernment of moist and shiny or withered and dried out color is the work of the good clinician.”

EXPLANATIONS AND COMMENTARIES

29.

I - Ma Shi explains: “This paragraph completes the previous one and speaks on the facial areas responding to the 5 organs and 6 bowels and joints of the limbs (Figure 2).

1 - The line which extends from Jue (inter-eyebrow space) to Ding (forehead) belongs to the facial area responding to the laryngo-pharyngeal system. The line which extends the length of the spine of the nose, that is to say, from Jue Zhong (middle of intereyebrow space) to Mian Wang (tip of the nose), belongs to the facial areas responding to the 4 organs: lung, heart, liver and spleen. The space separating the two lines which extend from the ocular canthii toward the point Chengqiang (CV 23) responds to the facial zones of the 6 bowels: gallbladder, stomach, large intestine (5), small intestine, bladder and uterus. Below the malar bone responds to the facial areas belonging to the upper limb: shoulder, arm, forearm and hand. The external area of the cheek (of the 2 maxilla) responds to the lower limb: thigh, knee, leg and foot. 2 - The colors each have a very specific area of appearance, thanks to which one can specify the localization of the disease of the Yin channel or Yang channel to therapeutic ends. Because, _ when the disease is found at the Yang channels, Yin is “interior”. One must use Yin to harmonize Yang, _ and when the disease is localized at the Yin channel, Yang is “exterior”. One must use Yang to harmonize Yin. In this connection, Chapter 9 of this classic (“Beginning and Ending”) has cited some examples: “Disperse gallbladder and tonify liver; dipserse liver and tonify gallblladder, etc.” Therefore, _ to delve deeply into the facial areas is to “practice 1000 and succeed at 1000”, _ to know how to differentiate left and right is to know the “Great Dao” (Great Principle), _ and to know how to differentiate boy and girl is to be able to discriminate Yin and Yang whose example has been cited in the following paragraph: “In boys, the appearance of color at the area located below Mian Wang (tip of the nose) is the indicator of the presence of an ailment of the lower abdomen, and in girls, the presence of an ailment of the bladder and uterus.”

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5. According to the text, “the large intestine sticks close to the kidney” because the kidney, responding to water, traveling up and down the circumference of the face, plays the role of protection of the royal palace (area of the heart) located at the center (Zhang Jing Yue).

II - Zhang Shi states: 30. “The appearance of red color at the two cheeks is fatal; death will take place on the day Ren-Gui (9th and 10th Celestial Trunks), at midnight. The appearance of black color at the forehead is mortal. The fatal day will take place on the day Wu-Ji (5th and 6th Celestial Trunks) and at the hours Chen, Xu, Chou and Wei (Vth, XIth, IIth and VIIIth Terrestrial Branches).”

III - N.V.N.: The different areas of appearance of “Color-Energy” at the level of the face are clearly described by Zhang Jing Yue: 1 - Ding (forehead) is called Tian Ding (celestial forehead) by astrologers. It is located at the uppermost part of the forehead. The appearance of the color-energy at this level is indication of pathology of the face and head. 2 - Jue Shang (above the inter-eyebrow space) designates the area which extends from the middle of the inter-eyebrow space toward the top. It governs laryngo-pharyngeal pathology. 3 - Jue Zhong (middle of the inter-eyebrow space) is the central area of the inter-eyebrow space. It responds to pathology of the lung and also bears the name Yintang (PC 3). 4 - Xia Gu (base of the nose) is the area located between the eyes. Astrologers give it the name Shangan (PC 4). The heart is located under the lung. Therefore, Xia Gu governs pathology of the heart. 5 - Chu Xia (crest of the nose) is named Nian Zio (long life) by astrologers. It governs pathology of the liver. Laterally, to the left of the liver, is the area which responds to the gallbladder. 6 - Mian Wang (royal domain or tip of the nose) is called Xuan Du (main standard) by astrologers. Xuan Du responds to Earth, located exactly at the middle of the face. For this reason, Mian Wang responds to pathology of the spleen. 7 - Fang Shang (culminating area: nasal ala) is found at the two sides of Xuan Du, located to the side of Yingxiang (LI 20), which responds to pathology of the stomach. Astrologers give it the name Lan Dai Ding Wui (altar of orchids - residence of officials). The spleen and stomach constitute one of the systems of external/internal relationship. The spleen is located at the center, and the stomach, at the exterior. As a result, Fang Shang are the areas responding to pathology of the stomach. 31.

8 - Here, the words Zhong Yan (central area) designate the middle of the cheek, that is to say, the area located outside Yingxiang (LI 20) and below the zygomatic bone. This area responds to pathology of the large intestine. Outside and below the large intestine area, that is to say, at the side of the cheek, the area responding to pathology of the kidney is found. The kidney is found at the level of the umbilicus. For this reason, just below the area of the kidney is the area responding to umbilical pathology.

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9 - The area located above Mian Wang (Xuan Du: tip of the nose) and inside the cheekbone responds to pathology of the small intestine. 10 - The area located below Mian Wang (Xuan Du: tip of the nose) and outside Renzhong (GV 26), that is to say, below Fang Shang (ala of the nose) responds to pathology of the bladder and uterus. The area of Renzhong (GV 26: nasolabial groove) flat and dried out, devoid of moustache, is the indicator of male sterility. In contrast, if it is deep and long, it indicates female sterilty. 11 - The zygomatic arch is the “root” of the entire skeleton. It is located above the central area of the cheek. It therefore responds to the shoulder, arm, forearm and hand. 12 - The external area of the cheek bears the name “Zang” (comrade). Above, it responds to the back. Below, the area of the 2 maxilla responds to the thigh, knee, leg and foot. 13 - Ju Fen (great separation) designates the labial commissure. It responds to the internal surface of the thigh. 14 - Ju Gua (great curvature) is the name given to the zygomatic bone, and Xi Xin, to the patella. 15 - Yi Ying Chi notes: “In boys, the energy ciruclates toward the left, and in girls, toward the right. This is the normal circulation, thus favorable, and the energy spreads... . In contrast, the opposite circulation is unfavorable and the energy stagnates..., hence phenomena of victory, domination and extermination. This paragraph speaks on the “Color-Energy” of endogenous cause centered on the favorable and unfavorable phenomena of the “left-right” movements of Yin and Yang.”

PARAGRAPH 11 “The dirty and dark gray color indicates disease localizing in the interior, that is to say, at the level of the organs. The shiny color is the indicator of disease localizing at the 3 2 . exterior, that is to say, at the level of the bowels. The red yellow color belongs to diseases of wind. The black green color indicates pain. The white color heralds cold. The slippery and damp yellow color (as if saturated with fat) indicates suppuration. The dark red color is the sign revealing the syndrome of blood stagnation which, in the serious state, causes spasm, and, in a state of excessive cold, causes paresthesia. • The 5 colors each have an area of appearance which is appropriate to them. As a result, it is necessary to examine: _ their slight or strong saturation to determine the superficial or deep localization of the disease. _ their shiny or faded luster to distinguish the prosperous or harmful signs of the disease. _ their dissemination or concentration to differentiate the acute or chronic state of the disease. _ their quality of emergence or immergence to study the evolutive state of the disease.

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• In this manner, the physician must concentrate his Jing-Shen (mental) during the examination of the colors. _ If the color without brilliance reveals an appearance of concentration and dryness, the disease is serious. _ In contrast, if the color without brilliance reveals an appearance neither too immergent nor too faded, the disease is still found in the benign state. _ The dissemination of the color is the indicator of the non-gathering of the disease; even if it expresses pain, the disease does not declare at any spot.”

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains:

“1 - This paragraph discourses on the examination of colors origining from diseases of external origin. The deep and impure color is the indicator of the disease localizing in the interior, and the superficial and brilliant color, the indicator of the disease localizing at the exterior. Therefore, to examine the deep and superficial color is to diagnose disease localizing at the exterior or in the interior. _ Wind is perverse Yang. Once inside the organism, it manifests by a red yellow color. _ Pain is Yin Bi (algoparesthesia at the level of Yin). It manifests by a black green color. _ White color is due to the presence of cold. _ Brilliant yellow color (like fat) is the indicator of the presence of suppuration. 33. _ Dark red color is the sign revealing blood stagnation. _ Pain is located, in the majority of cases, in the tendon, and in the serious case, it manifests by spasm. _ Excessive cold injures the pilo-cutaneous system, and in the serious case, it is the cause of paresthesia. Such are the 5 colors of external etiology each possessing an area of appearance which is appropriate to them. 2 - The superficial color and deep color permits diagnosing the benigness and seriousness of the disease. The smooth color (with brilliance) and withered (dried out) color allows recognition of the favorable and unfavorable signs of the disease. The diffuse (disseminated) color and concentrated (accumulated) color permit recognition of acute and chronic disease. The color localizing at the top and the color localizing at the bottom permit diagnosing the localization of the disease. 3 - Complexion and pulses are different important clinical components transmitted by our old masters. From antiquity, Shua Tai Qi concentrated his Jing Shen (mind. mental) during examination of the pulses and colors as a function of the 5 Movements, 4 Seasons, “8 Winds” and “6 Regions” (space of time??) without impeding or thwarting the rules of the natural world. As a result, our Jing Shen must be concentrated on the past and present during the determination of acute disease and chronic disease. If the color without brilliance is pallid (pale grey), the disease is serious. In contrast, if the color without brilliance is not yet withered, the disease is benign... . It concerns diseases of external etiology; this is why, it is recommended to let them disseminate to the exterior and not to the interior.”

II - Ma Shi comments:

“This paragraph completes the previous one and speaks on the appearance of the colors at the level of the

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different areas of the face in the determination of the disease. 1 - The color is deep and of variable color: _ If the color is deep and impure, the disease is located within the interior (organs). _ If the color is superficial and brilliant, the disease is located at the exterior (bowels). _ Yellow associated with red indicates wind. _ Green associated with black, pain. _ White, cold. _ Shiny yellow (like a greasy coating), suppuration. _ Dark red, blood But the worsening of the pain can cause muscular spasm, and that of cold, paresthesia. 34.

2 - The five colors each have an area of appearance which is appropriate to them. One must clearly observe: _ their appearance in order to determine the seriousness and benignness and the acute and chronic state of the disease _ and their location (top and bottom) in order to determine the upper or lower localization of the disease. 3 - One must concentrate the Jing Shen during the search for the past and present of the acute disease and chronic disease. The colors must be studied with precision: _ if the dull color (without brilliance) is characterized by a pale gray (pallid) and dried out appearance, the disease is serious. _ if the color is slightly brilliant and withered, the disease is not yet at its extreme phase. In summary, the pallid color is from fear.”

PARAGRAPH 12 “The diffuse color is indicator of the disease in full evolutive phase indicated by a painful syndrome and not by a syndrome of gathering.” EXPLANATIONS AND COMMENTARIES Ma Shi explains: “This paragraph completes the previous one and speaks on the diffuse nature of the disease still localizing in the energetic layer, the origin of pain. This is then due to the disseminated nature of the complexion that one determines the non-gathering quality of the disease.”

PARAGRAPH 13

“The kidney encroaches on the heart and reflects its color at the exterior because the heart is primarily affected. This is the reactive phenomenon of the kidney. All appearances of colors (of the 5 organs) conform to this correlation.”

EXPLANATIONS AND COMMENTARIES I - Ma Shi explains:

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“This paragraph completes the previous one. All diseases manifest in the first place by a color of encroachment (coming from the inhibitory organ). As a result, the inhibited site is certainly pathologic. 35. According to the previous paragraph, Xia Gu (base of the nose, between the eyes, where the point ShanganPC 5) is found) is the site of concentration of Jing (quintessence) of the heart responding to the color red. As a result, the appearance of black color at Xia Gu (base of the nose) originates from the phenomenon of encroachment of the kidney on the heart. This reactive phenomenon is also encountered at the level of the facial areas of the other organs: _ appearance of white color (lung) at the facial area of the liver _ appearance of red color (heart) at the facial area of the lung _ appearance of yellow color (spleen) at the facial area of the kidney _ appearance of greenish color (liver) at the facial area of the spleen. It is the same for the 6 bowels.”

II - N.V.N.: This paragraph demonstrates the mechanism of appearance of the colors of the 5 organs at the level of the face, according to the inhibitory chains of the law of the 5 Movements (Figure 3), conforming to the principle according to which everything that manifests at the exterior is the expression of that which occurs in the interior.

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Figure 3: Manifestations of the colors of the inhibitory organs at the level of the facial areas belonging to the inhibited organs.

PARAGRAPH 14

36.

“ • In man, _ the appearance of the color above and below Zian Wang (tip of the nose) indicates pains in the lower abdomen. _ the appearance of the color underneath Zian Wang heralds testicular pains. _ the appearacne of the color at Renzhong (nasolabial grooveGV 26) reveals pain of the penis. _ the appearance of the color at the upper half of Renzhong heralds pains of the root of the penis (body of the penis). _ the appearance of the color at the lower half of Renzhong indicates pains at the tip of the penis (glans). Generally, these pains originate from Hui Shan (inguinal hernia, ectopia...) or from Dui Shan (scrotal hernia, hydrocoele...). • In woman, _ the appearance of the color underneath Zian Wang (tip of the nose) is the sign revealing the presence of illness of the bladder and uterus (genito-urinary illnesses). _ if the color is disseminated, it indicates the painful syndrome caused by an energetic stasis. _ if the color is concentrated, it denotes blood stasis with formation of Ji Ju (illness of accumulation/gathering: tumorous illness) of the rounded or square type, localized at the left or right. _ if the color reaches the bottom (of Renzhong: nasolabial groove), it heralds disease of the coccygeal region, or else an excretion of thick substance (leukorrhea), or else an evacuation of impure liquid substance (diarrhea) resulting from a digestive disorder ( 6 ) .

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• The color localizing to the left, the illness is to the left; the color localizing to the right, the illness is to the right. The color in relation to the perverse energy becomes concentrated or dispersed in non-specific fashion. Also, one must base one’s judgment on the colors (at the level of the face) in order to determine the disease.”

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains:

“The area located outside and above Zian Wang (tip of the nose) responds to the small intestine, and that of below Zian Wang, to the bladder. 37. • In boys, the appearance of color at the two sides of Zian Wang indicates lower abdominal pains, and the color underneath Zian Wang, pains of the penis. Diseases of exogenous etiology progress from the exterior toward interior and the color from the top downward. Therefore, the upper part of Renzhong (nasolabial groove-GV 26) responds to the “root” of the penis, and the lower part of Renzhong, the “summit” of the penis (glans). Generally, pains in these parts of the penis originate from Hui Shan (inguinal hernia, ectopia...) or from Dui Shan (scrotal hernia, hydrocoele...). • In girls, the appearance of color in the region under Zian Wang indicates disease of the bladder or uterus. • In boys and girls, disease localizing within the energetic part becomes indicated by a painful syndrome, and those localizing in the blood part, by a syndrome of stagnation with formation of Ji Ju (accmulation/gathering: tumorous formation). • The 5 organs and 6 bowels are endowed with external areas and corresponding internal areas. To know these areas is to “treat 10, cure 10”. The coccyx responds to the lower area of Renzhong (nasolabial groove). The color of Zian Wang (tip of the nose) descending to the area of the coccyx is the sign revealing leukorrhea. If the color is glistening like grease, it involves diarrhea caused by a digestive disorder. • The bowels are Yang and govern the exterior. They are endowed with the function of reception of Shui Gu (Water-Cereals) and the excretion of food residues. This is why, at the exterior, they are open to attack by ColdWind, and at the interior, to digestive problems. Each 6. In other words, in this case, disease can be found at the same time at anterior Yin (vagina) and at posterior Yin (anus).

bowel possesses its own area of appearance of color. As for the color appears at the left, the disease is at the left and vice versa. • Generally, a direct and severe attack of the blood and energetic routes linked to the organs is the cause of sudden death. In our case, it is a matter of disease of the bowel in the form of Hui Shan (inguinal hernia, ectopia...) and Dui Shan (scrotal hernia) whose perverse energy accumulates and concentrates to become Ju (gathering) disease and not Ji (accumulation) disease. This comes down to saying that the disease of the bowel is not a fatal syndrome.”

II - Ma Shi concludes:

“In girls, the appearance of color at Zian Wang (tip of the nose) and at Renzhong (nasolabial groove) is the sign revealing a genito-urinary ailment. Diffuse color indicates a painful syndrome. 38... Concentrated color heralds not only a painful syndrome but also a Ji (Gathering) disease of round or

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square form localized to the left or right whose reactive phenomenon manifests at the face by a color which joins the same form and the same location with that of the disease. If the color of Zian Wangdescends toward the lower part of Renzhong, it heralds a disease localizing at the bottom, leukorrhea. If the color is brilliant and shiny like grease, it indicates a diarrhea of digestive origin.”

III - N.V.N.: The nasolabial groove has two names: 1 - Renzhong (center of being). It is named in this way because Renzhong (GV 26) is a point of reamination reestablishing the connection of the sense organs (eyes, nose, mouth and ears) in the event of loss of consciousness (coma). 2 - Shuigou (channel of outflowing). It is named in this manner because it is the site of reunion/meeting of the Dumai (GV: Sea of Yang Channels = water) and the Hand Yangming (LI). 39...

Renzhong (or Shuigou: GV 26) is located on the junction point of the upper 1/3 upper and lower 2/3 of the nasolabial groove. Energetically, the nasolabial groove is the reactive site of pathology of the genito-urinary system (site of appearance of pathologic color).

38....

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Figure 4: Reactive site of genito-urinary pathology.

39...

PARAGRAPH 15 “Green, black, red, white and yellow are called the “5 colors”. Each of these colors is endowed with a characteristic area of appearance. If this particular area is of red color, the color is red. If the red color, as large as a pit of elm, appears at Zian Wang (tip of the nose) , it indicates the chronicity of the disease.” EXPLANATIONS AND COMMENTARIES I - Ma Shi explains:

“This paragraph speaks on the distinct areas of the appearance of the 5 colors. Each color must appear in a clear-cut and precise fashion at the level of the distinct area which belongs to it. Therefore, for example, the red color belongs to the heart, but also to the small intestine. If the red color, as large as an elm pit, manifests at Zian Wang (tip of the nose), it denotes the chronic, not acute, state of the disease of the small intestine.”

II - Zhang Shi comments:

“The fatal color of the 5 organs manifests at the area which does not belong to it. Thus,

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_ when the heart receives perverse energy coming from the exterior, sudden death manifests by a color belonging to Zian Wang (tip of nose). _ when the heart is contaminated by disease coming from another organ (endogenous origin), sudden death is indicated by the appearance of red color at the level of Quan (cheekbone).”

III - N.V.N.: This passage has been interpreted differently over the course of the centuries. One recent Franco-German version is incomprehensible. The explanation of Ma Shi is most plausible. Zhang Jing Yue concludes: 40. “There are 5 colors. At the time of their appearance, each of them must assume a consistent and complete appearance at the level of the area which corresponds to it. Outside of this normal manifestation, the color can appear in an inappropriate area. Therefore, red color at Zian Wang (tip of the nose) is an abnormal phenomenon.” The Li Family adds: “The red color belongs to the heart. Normally, it must manifest at Xia Gu (base of nose, between the eyes). The appearance of red color at Zian Wang (tip of the nose) originates from the route of production of the law of the 5 Movements: Heart-Fire creates Spleen-Earth”.

PARAGRAPH 16 “When the color has a pointed form at the top and rounded at the bottom, it indicates great emptiness of the energy of the cephalic region. For this reason, the perverse energy profits from this emptiness to flow (afflux) toward the top. It is the same for the color oriented toward the bottom, toward the right or toward the left. • During the use of the colors to determine the 5 organs:

_ _ _ _ _

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green belongs to the liver red, to the heart black, to the kidney white, to the lung yellow, to the spleen

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........................................................ _ _ _ _ _

the the the the the

liver unites with the muscles heart, with the vessels kidney, with the bones lung, with the skin and hair spleen, with the flesh (dermis).”

EXPLANATIONS AND COMMENTARIES I - Ma Shi explains:

“The 5 colors belong to the 5 organs, and the 5 organs are their “union”. Such is the principle of determinism of the understanding of the colors. Therefore, in the case of green color belonging to the facial area of the liver, diagnosis is immediately directed toward the muscles. It is the same for the other colors of the other organs.”

II - N.V.N.:

41.

This paragraph shows: _ the reason for the progression of perverse energy as a function of the form of the color _ and the principles of utilization of the 5 Colors in the determination of the disease.

no 42/43.

CHAPTER 31

L

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Discussion on Courage (Luan Zung)

Chapter 50 of the Lingshu describes, in global fashion, the different degrees of attack of disease as a function of color (green, yellow, red, white and black) and of the appearance of integument (supple or dried, fresh or crumpled, radiant or dull) on the one hand, and, on the other hand, as a function of the courage and cowardice of the individual. These states are intimately linked to the emptiness or fullness of the internal organs, in particular of 3 organs: Heart, Liver and Gallbladder. The essential object of this chapter is to speak on the meaning of courage and cowardice in diagnosis and treatment. This is why it is titled: “Discussion on Courage (Luan Dung)”. Ma Shi emphasizes: “The contents of this chapter discusses the topic of courage or weakness, supporting or not supporting pain, hence the title of this chapter.” This chapter contains 4 paragraphs.

PARAGRAPH 1 Huangdi questions Shao Shu: “Take among us some individuals who move about or stay in place together, of the same age and wearing the same garments of the same thickness. Upon encontering a severe wind or beating rain, some are sick and others are not, or they are all affected or all unharmed... . What is the cause of this disparity?” Shao

Shu answers: 44. “About which type of individual does His Majesty wish to be informed frist?”

Huangdi: “Teach me about them all.” Shao

Shu: “Spring is dominated by Sheng Feng (Pure Wind) or Feng Wen (Moderate Wind-Heat).

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Summer, by Yang Feng (Yang Wind o r Wind-Heat). Autumn, by Liang Feng (Wind-Cool). Winter, by Han Feng (Wind-Cold). These winds of the 4 Seasons are susceptible to provoke diseases with different symptomatologies.” Huangdi: “What is the process of triggering of the disease of Wind of the 4 Seasons?” Shao

Shu: “The individual of yellowish color, with thin skin and soft flesh, cannot endure the harmful wind of spring. The individual of whitish color, with thin skin and soft flesh, cannot endure the harmful wind of summer. The individual of greenish color, with thin skin and soft flesh, cannot endure the harmful wind of autumn. The individual of reddish color, with thin skin and soft flesh, cannot endure the harmful wind of winter.” Huangdi: “Therefore, the individual of blackish color cannot be sick during the 4 Seasons! Is that true?” Shao

Shu: “The individual of blackish color, with thick skin and firm affected by the harmful wind of the 4 Seasons. In contrast, if his his flesh not firm with non-specific color, he can be sick in the harmful wind of the end of summer. 45. He can also be sick when Wind (Feng), associated with Cold exterior just as easily as the interior.”

flesh, cannot be skin is thin and presence of the (Han), reaches the

Huangdi: “Correct!” EXPLANATIONS AND COMMENTARIES I - Zhang Shi exlains:

“Shao Shu evokes the image of the presence of the harmful and perverse Wind of the 4 Seasons, like: _ Sheng Feng (pure wind, also called Feng Wen or Wind-Warm, moderate Heat-Wind) of spring. _ Yang Feng (or Feng Re: Wind-Heat) of summer. _ Liang Feng (Wind-Cool) of autumn. _ Han Feng (Wind-Cold) of winter. 1 - Yellow color, thin skin and soft flesh are the signs revealing insufficiency of the Spleen. In the presence of these signs, the individual cannot tolerate Sheng Feng of spring because of the invasive action of Wood-Wind on Spleen-Earth. White color, thin skin and soft flesh are indicators of insufficiency of the energy of the Lung. In the

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presence of these signs, the individual cannot tolerate Yang Feng of summer due to the invasive action of HeartFire on Lung-Metal. Green color, thin skin and soft flesh indicate insufficiency of the energy of the Liver. In the presence of these signs, the individual cannot tolerate Liang Feng of autumn due to the invasive action of Lung-Metal on Liver-Wood. Red color, thin skin and soft flesh are the signs are insufficiency of the energy of the heart. In the presence of these signs, the individual cannot tolerate Han Feng of winter due to the invasive action of KidneyWater on Heart-Fire. 2 - In contrast, the individual of black color, with thick skin and firm flesh, cannot be attacked by the harmful wind of the 4 Seasons. In a general fashion, the individual of black color having thin skin and soft flesh is easily injured by the harmful wind of the end of summer. This wind of the 6th month (lunar) is of the same type as Yang Feng (Yang Wind or Wind-Heat). The illness then originates from the invasive phenomenon of Earth on Water. The individual of black color, with thick skin and firm flesh, can become ill if he is first offended by Cold, then secondarily by Wind. In other words, he can only be affected if the interior is already affected by Cold (of internal origin), then afterward by Wind (of the exterior, external origin). If not, in him, the triggering of the disease of Wind (external) proves to be difficult. Such is the characteristic of the black color.” 46.

II - N.V.N.: Zhang Jing Yue clarifies the subject of Feng as: _ Sheng Feng (or Wen Feng) of spring receives the “Wood” energy. _ Yang Feng (Wind-Heat) of summer receives the “Fire” energy. _ Liang Feng (Wind-Cool) of autumn recieves the “Metal” energy. _ Han Feng (Wind-Cold) of winter receives the “Water” energy. The winds of the 4 Seasons each have a plethoric phase and an inhibited phase (Figure 1). Therefore, the diseases differ one from the other.

Figure 1:

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System of stimulation/inhibiton (a) and revolt/invasion (b) of the 5 Movements.

Still following this same commentator:

Yellow color is the color of “Earth” energy. The one who has a yellow color, thin skin and soft flesh is affected by insufficiency of spleen energy. Therefore, he cannot triumph over the harmful wind of Wood-Spring, hence illness. White color is the color of “Metal” energy. The one who has white color, thin skin and soft flesh is affected by insufficiency of lung energy. Therefore, he cannot triumph over the harmful wind of Fire-Summer, hence illness. Green color is the color of “Wood” energy. The one who has green color, thin skin and soft flesh is affected by insufficiency of liver energy. Therefore, he cannot triumph over the harmful wind of Metal-Autumn, hence illness. 47.

Red color is the color of “Fire” energy. The one who has red color, thin skin and soft felsh is affected by insufficiency of heart energy. Therefore, he cannot triumph over the harmful wind of Water-Winter, hence illness. Black color is the color of “Water” energy. The one who has thin skin and soft flesh with non-specific (changing) black color is affected by insufficiency of kidney energy. Therefore, he cannot triumph over the harmful wind of the end of summer, hence illness. In contrast, the one who has black color with thick skin and firm flesh cannot become ill during attack by harmful wind of the end of summer. But, he can become ill if it follows attack by wind and cold, cold of the interior (of endogenous origin) and wind of the exterior (of exogenous origin). In total, according to the state of the skin and flesh, black color can trigger diseases of different causes.

PARAGRAPH 2 Huangdi: “The capacity to tolerate or not tolerate pain does not depend on the strength or weakness of the individual. The courageous man not tolerating pain fears neither danger nor pain. The weak man faced with pain sees only the danger and the pain; he closes his eyes and moans like he is going to pass out. In such cases, I ignore the causes. Tell me about this.” Shao

35

Shu: “The capacity to tolerate pain or not tolerate it depends on the thickness of

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the skin and firmness of the flesh and not on the courage or weakness of the individual.”

EXPLANATIONS AND COMMENTARIES Zhang Shi explains:

“This paragraph speaks on the distinction between Xing (form) and Qi (energy). “To tolerate or not tolerate the pain” depends on the thickness of the skin and firmness of the Xing (form). “Courage or cowardice” depends on the power or weakness of the Qi (energy). The previous paragraph is based on courage in order to determine the energy, while this one analyzes in specific fashion form (Xing) and energy (Qi).”

PARAGRAPH 3

48.

Huangdi: “I want you to tell me about the nature of courage and weakness.” Shao

Shu: “In the courageous _ the eyes are deep and penetrating _ the vessels of the “flesh” system _ the energy of the _ the energy of the _ the energy of the

man, and steady, great and large; the gaze is straight Sanjiao (SJ) are spread out in width over the heart is “loyal” and “sincere” liver is “generous” and “solid” gallbladder spreads widely toward the 4 limbs.

During anger, _ the energy is in fullness, and the thorax, distended _ the energy of the liver revolts and that of the gallbladder is unleashed _ the eyes seem to leave the orbit _ the gaze is severe and eyelashes stand on end _ the facies becomes greenish. Such is the nature of the courageous man. Huangdi:

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“And the weak man?” Shao

Shu: “In the weak man, _ the eyes are large but not tightly closed; eyelid movements are uneven _ the color and energy, Yin and Yang, are easily lead astray _ the vessels of the Sanjiao (SJ) spread out in width _ The xiphoid appendage is short and small _ the liver is lax; the gallbladder is deprived of its ease and is left sagging _ the intestines and stomach lose their tonus and the hypochondrial area is in emptiness. During anger, _ the energy does not fill the thorax _ the energy of the liver and gallbladder swells up, but deflates immediately. This is why, in him, anger does not last long. Such is the nature of the weak man.”

EXPLANATIONS AND COMMENTARIES

49.

I - Zhang Shi explains: “1 - This paragraph discourses on the courageous man and weak man endowed with a “large” or “small” heart, endowed with energy in a plethoric or insufficient state, with a liver and gallbladder in a state of power or weakness. _ “Eyes deep and steady; straight and penetrating gaze” indicates the power of the energy of the liver. _ “Vessels of the Sanjiao (SJ) spread widely out” indicates the power of the energy of the Shaoyang with a gallbladder of large size. _ “The energy of the heart is “loyal” and “sincere” and that of the liver “generous” and “solid” are the indicators of the power of the energy of the Heart-Liver system. • The heart is the sovereign organ. It is the seat of the Shen-Ming (mental-clarity). The liver has the function of general. It is the strategist of the entire organism. The gallbladder is a “loyal” and “honest” bowel which respects the code of honor and integrity. It is that which holds the power of decision. This is why a “straight” heart with a powerful energetic state, a liver of great size and a very full gallbladder... are so many components belonging to the courageous man.

2 - In contrast, large eyes with not tight, uneven eyelid movements are encountered in the weak individual whose energy and blood are in disharmony, liver and gallbladder are in a state of weakness and emptiness. The lung is the “master of the energy”. In the event of anger, the energy barely succeeds in filling the thorax... . This is why anger does not last long. Such is the nature of the weak man.”

II - N.V.N.: According to Zhang Jing Yue, the distinction between the courageous and weak man basically resides in the energetic state of the Liver/Gallbladder system because:

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_ the liver has the function of “general” _ and the gallbladder, the power of “decision”. 1 - In the courageous man, _ “deep eyes” indicate the stability of the energy of the organs because the eyes are the sites of gathering of the Jing (quintessence) of the 5 organs and 6 bowels. _ “the Sanjiao (SJ) spreads out widely...” marks the solidity of the muscular system. In contrast, in the case of fragility of the epidermo-dermal system, it circulates only in the direction of length, that is to say, in the direction of the tissue fibers. 50. _ “The “loyal” and “sincere” energy of the heart” indicates the energetic and firm state of the courageous man. _ “The energy of the gallbladder spreads out widely toward the 4 limbs” implies the sense of abundance of the energy diffusing to the 4 sides more openly than in the normal individual. _ “In the event of anger, the energy is found in a state of fullness, the thorax enlarges and the eyes seem to leave the orbit...” denotes the plethoric state of the energy of the liver and gallbladder. _ “The energy of the liver revolts, rises up... and the eyelashes stand on end” heralds the overflowing of the energy of the liver toward the exterior. 2 - In the weak man, _ “The eyes are large but not tightly closed” indicates the fragility of the Shen (mental). _ “The color and energy, Yin and Yang easily go astray” means that the weak man is easily open to problems of blood and energy which is characterized by an impertinent and fearful glance. _ “The Sanjiao (SJ) does not spread out in width” indicates that its energy, in a state of weakness, only spreads out in length following the tissue fibers. _ “The xiphoid appendage is short and small” is the sign revealing the modest and subdued state of the energy of the heart. In that case, the individual constantly wants to humble himself before others. _ “The liver is lax and the gallbladder sagging. The stomach and intestines lose their tone” are indicators of insuficiency of the energy of the Liver/Gallbladder system. This is why anger does not last a long time in the weak man.

PARAGRAPH 4 Huangdi: “In the weak man indulging in alcohol, the bout of anger is the same as in the courageous man. What is the organ responsible for this state?” Shao

Shu: “Alcohol is a pure substance coming from Shui Gu (Water-Cereals), that is to say, a substance fermented from cooked rice endowed with an agile and fierce energy. Once in the stomach, it causes gastric swelling, energetic circulation in the wrong direction toward the thorax, uprising of the energy of the liver and overflowing of the energy of the gallblader. During the bout, the weak man grows to be brave. But after the bout, he feels remorse. 51. Therefore, despite the fact that, like the brave man, the weak man does not recognize fear, this state is the consequence of inebriation.”

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EXPLANATIONS AND COMMENTARIES Zhang Shi explains:

“Alcohol is a substance distilled from Shui Gu (Cereals-Water). Its energy is rapid and powerful. It has the property of augmenting the energetic potential, particularly that of the liver and gallbladder. But once the bout of inebriation is over, the energy grows weak and the individual has a feeling of regret and guilt. This is why, the one who knows how to maintain his energy, eat with moderation and work moderately preserves Xing (form) and Qi (energy). In general, excess of joy injures Yang and excess of anger injures Yin. To know how to harmonize joy and anger is to allow Yin and Yang to agree with the “Natural Rules”. The individual endowed with a robust and flourishing Xing (form) and Qi (energy) does not fear attack of great wind and strong rain a fortiori, even more certain in the event of the harmful wind of the 4 Seasons.” Yi Shi has said: “The power of the energy of an individual depends on that of a heart which is “loyal” and “sincere”, on that of a liver which is “generous” and “solid” and that of a gallbladder which is “abundant” and “very full”. This energy (Qi) originates from Xing (form). In contrast, the thorax in distention (presence of energy), causing an uprising of the liver and overflowing of the gallbladder, originates from the energy (Qi) which produces the form (Xing). Xing (form) and Qi (energy) are inseparable. Such are the “natural rules” of the creation of form (Xing) and the determination of energy (Qi), rules created by nature which serve as a basis in the study of longevity and brevity of life.”

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no 52/53.

CHAPTER

LI

Shu of the Back (Bei Shu)

Chapter 51 of the Lingshu speaks on the localization of a group of specific acupuncture points located in the dorso-lumbar region, like the points Dazhu (Bl 11), Genshu (Bl 17)... and the dorsal Shu points of the 5 organs (Lu, He, Li, Sp and Ki). In the interior, these dorsal Shu points are connected to the 5 organs, and at the exterior, they are connected to the sites of Gathering-Reunion of the energy. Therapeutically, they have obvious specific effects, but in practice, deep needling of these

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points is strictly prohibited. This is why moxabustion is specifically advised, and acupuncture cannot be used without reflection. The method of examination of these particular points is well developed here. Tonification and dispersion by moxabustion are also presented. The essential object of this chapter is to determine the location of these points, hence the title: “Shu of the Back” (Bei Shu). This chapter consists of only one paragraph.

Huangdi questions Qi Bo: “Please teach me about the Shu of the 5 organs which are all located on the back.” 54.

Qi Bo replies: “ Dazhu (Bl 11; Great Shuttle) is found outside the spinal apophysis of the 1st dorsal vertebra, in the 1st intercostal space. Feishu (Bl 13; Shu of the Lung) is found outside to the spinal apophysis of the 3rd dorsal vertebra, in the 3rd intercostal space. Xinshu (Bl 15; Shu of the Heart) is found outside the spinal apophysis of the 5th dorsal vertebra, in the 5th intercostal space. Geshu (Bl 17; Shu of the diaphragm) is found outside the spinal apophysis of the 7th dorsal vertebra, in the 7th intercostal space. Ganshu (Bl 18; Shu of the Liver) is found outside the spinal apophysis of the 9th dorsal vertebra, in the 9th intercostal space. Pishu (Bl 20; Shu of the Spleen) is found in outside the spinal apophysis of the 11th dorsal vertebra, in the 11th intercostal space. Shenshu (Bl 23; Shu of the Kidney) is found in outside the spinal apophysis of the 14th vertebra, that is to say, the 2nd lumbar. • The Shu points of the 5 organs are all found on the line parallel to the midline of the spine, 1.5 cun apart from it. • In order to locate the Shu of the back, press firmly with the aid of the finger on the concerned area. When the patient feels a sensation of relief in the interior, the concerned area is the point sought. • Therapeutically, moxabustion is absolutely advised, and acupuncture, without reflection, is strictly forbidden. Disperse in the event of fullness, and tonify in the event of emptiness. • During the use of fire (moxa) to tonify, do not blow on the fire to put it out,

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but allow it to die out by itself. • During use of fire (moxa) to disperse, blow on the fire to help it go out; then on the field, replace it with another fire (moxa) which must also rapidly go out.”

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains: “1 - The Shu points of the 5 organs and 6 bowels are all found in the dorso-lumbar region and Huangdi’s question concerns only the Shu points of the 5 organs because: _ the bowel and organ constitute the male/female system _ the study of the 5 Movements of the Earth is largely sufficient. 55.

2 - The vertebral column is the site of passage of the Dumai (GV). All the dorsal Shu points are bilateral and are found 1.5 cun aside from the Dumai (GV), that is to say, from the posterior midline of the body (that is to say, 3 cun between the 2 bilateral points). Therefore: _ Dazhu (Bl 11) is found 1.5 cun apart from the 1st vertebra _ Feishu (Bl 13) is found 1.5 cun apart from the 3rd vertebra _ Xinshu (Bl 15) is found 1,5 cun apart from the 5th vertebra _ Geshu (Bl 17) is found 1.5 cun apart from the 7th vertebra _ Ganshu (Bl 18) is found 1.5 cun apart from the 9th vertebra _ Pishu (Bl 20) is found 1.5 cun apart from the 11th vertebra _ Shenshu (Bl 23) is found 1.5 cun apart from the 14th (2nd lumbar) vertebra. 3 - “Relief in the interior during pressure of the finger at the level of the intercostal space” denotes the existence of communication between the Taiyang (Bl) and Dumai (GV ). This is why, regarding the Shu points of the 5 organs, one reaches first the point Dazhu (Bl 11) because it is found at the end of the great bone located at the nucha, that is to say, at the 1st vertebra belonging to the Dumai (GV). (1) 4 - “One questions about the 5 organs and one reaches Geshu (Bl 17; Shu of the diaphragm) located 1.5 cun apart from the 7th vertebra” because the energy of the 5 organs is propelled by the diaphragmatic movements. This is why there is a saying according to which “the small heart (Xiao Xin) lives in the interior, to the side of the 7th vertebra”. In general, every attack of the diaphragm causes a serious internal pathology whose cure is only apparent; death surely follows at the end of one year. 5 - The Shu points of the 5 organs are all on the Foot Taiyang because the bladder is a Water-Bowel and the 5 Movements of Earth are produced by the Water of Heaven. 6 - Pressure of the finger performed on the Taiyang channel provokes a reaction at the level of the Dumai (GV) because “Water-Cold” of the Taiyang (Bl) and that of the Dumai (GV) unify all the Yang channels of the body and because Yin and Yang, Water and Fire, communicate. 7 - Moxabustion is recommended because it has the property of activating the production of the energy of the Organ-Yin. Acupuncture is advised against because it injures: _ the energy of the heart; death is immediate _ the energy of the spleen; death follows in 5 days 56. _ the energy of the kidney; death follows in 7 days _ the energy of the lung; death follows in 9 days.

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Here, it is a question of the energy located at the Shu points of the back of the organs and not of a deep effect of the organ by the needle stick. 8 - To use fire (moxa) to tonify is to apply the principle according to which one maintains Water by Fire. To use fire (moxa) to disperse is to obey the principle according to which one obtains Fire from Water to revive the Yin energy of the organ. To blow on the fire (moxa) is to wish to direct the energy toward the exterior. 9 - Regarding Water and Fire, Chu Shi has described: “_ I-Heaven creates Water _ II-Earth creates Fire. This Water and this Fire are the 2 components, Yin and Yang, of the First Principle (Tai-Yi) which comes from building up. The Human Being receives these 2 energies, 1. This explanation is not very precise. See below.

Water and Fire of Yin and Yang, which become transformed into the 5 Movements to construct the bodily form. This is why the Shu points of the back of the 5 organs all have their “root” (Ben) at the Taiyang (Bl = Water) and respond to the Dumai (GV = Sea of Yang Channels = Water).”

II - N.V.N.: This chapter involves the location of the points Dazhu (Bl 11) and Geshu (Bl 17) and the dorsal Shu points (Bei Shu) of the 5 organs located on the back. a - “Moxabustion is indicated and acupuncture is advised against.” It concerns advice given to novice physicians because deep needling the dorsal region can injure the lung and heart and cause serious accidents. This does not mean to say that acupuncture performed on the back is strictly forbidden as proportionately less of this classic (Lingshu) and the Suwen had developed in several chapters the methods of needling practiced in this region. From Chapter 20 of the Lingshu (“The Five Perverse”), Paragraph 1, Volume I: “It is necessary to needle... the point apart from the 3rd dorsal vertebra. Needling this point is confirmed by a sensation of relief during pressure of the fingers.” From Chapter 22 of the Lingshu (“Yin Madnesses and Yang Madnesses”), Paragraph 18, Volume II: “It is necessary to needle the points... at the spot where the cough responds to pressure of the hand and the Shu points of the back (Bei Shu) at the spot where the patient feels a relief upon pressure of the fingers.” From Chapter 55 of the Suwen (“Complementary Study on the Chapters of the Depth of Needling”), Paragraph 1, Volume II: “In the chronic affliction of the 5 organs, needling must approach the organs at the level of the Shu points of the back (Bei Shu)...”. 57...

b - Effects of moxabustion. In the case of non-cure of some illnesses treated by acupuncture, moxabustion proves to be more effective and safer, particularly in the case of: _ chronic diarrhea of “Yin Cold” etiology _ “Humidity-Phlegm” _ afflux of cold _ evolutive polyarthritis (Wei Bi) _ “False Heat”... . In a word, the essential action of moxabustion is to make the Yang return and stop the escaping of the essential energy, hence the theory acccording to which “moxabustion tonifies emptiness.”

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c - Tonic action of moxabustion. This chapter 51 of the Lingshu stresses not only the importance of the tonifying action, but also that of the dispersant action of moxabustion. As a result, the use of moxabustion must be adapted to the form the disease takes. Therefore, for example: 58. _ in tonsillitis and epistaxis, moxas are applied to the point Shaoshang (Lu 11)... _ in grippe of “Wind-Cold” origin, moxas are applied to the points Fengchi (GB 20), Fengmen (Bl 12) Dazhui (GV 14)... _ in the disease “Yang-Liver” (hepatitis), moxas are applied to the point Yongquan (Ki 1). These illnesses make up part of the group of “fullness”, “heat” (fever) group. As a result, the theory according to which “moxabustion is only used for tonification” does not consider the true domains of moxabustion. 57....

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Figure 1: Points Dazhu (Bl 11) and Geshu (Bl 17) and the back Shu points of the 5 organs.

59.

CHAPTER LII Defensive Energy (Wei Qi)

Chapter 52 of the Lingshu speaks on Ying Qi (Rong: nutritive energy) and Wei Qi (defensive energy) and the internal activities of the organism. In practice, it is necessary to base one’s judgment on the system of Jingluo (principal and secondary channels) and on the notions of Jiao (summit) and Ben (root), of emptiness and fullness. To understand the notion of emptiness and fullness is to be capable of performing the techniques of tonification and dispersion. In this manner, in Chapter 52 of the Lingshu, are solved the problem of Jiao/Ben of the 3 Yang of the foot and the problem of Qi Jie (path of entry and exit of the energy) of the 6 bowels. This chapter therefore places emphasis on the importance of the points of the channels equipped with the indispensible“Jiao/Ben” systems in the implemention of diagnostics and therapeutics. This study is consequently fundamental to the resolution of the problem of the protection of

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the organism against the aggression of perverse energy and the problem of harmonization the interior (Li) and exterior (Biao) of the body. This is why this chapter is entitled “Defensive Energy” (Wei Qi). Ma Shi emphasizes: “The contents of this chapter do not involve in specific fashion the Wei Qi. The title is only used only to emphasize the importance of the defensive energy (Wei Qi).” Chapter 52 contains 5 paragraphs.

PARAGRAPH 1 Huangdi: “The 5 organs (Zang) are the receivers of Jing Hun (vegetative soul) and Po (sensitive soul).

(quintessence),

Shen

(mental) ,

The 6 bowels (Fu) are the receptors/metabolizers of Shui Gu (Water-Cereal: foods) . 60.

The Qi (energy, originating from foods) within the interior is linked to the 5 organs, and at the exterior, it is in relationship with the articulations. The Qi emerging at the exterior and not following the routes of the channels is Wei Qi (defensive energy) . The Qi circulating within the channels is Ying

Qi

(nutritive

energy) .

Yin and Yang mutually follow one another.

Interior (Li) and Exterior (Biao) communicate like a circle without end or beginning. The numerous branches and ramifications do not become entangled. They are easily detectable. But the distinction of Yin and of Yang comprises the notions of Jiao (summit) and Ben (root) , of emptiness and f u l l n e s s , and of the sites of liason. • _ _ _ • of the _ _

Discerning Yin and the Yang permits determination of: the site of origin of the illness the site of emptiness and of fullness and the superficial or deep localization of the illness. Knowing 6 bowels the site and the

the Qi Jie (sites of entering and exiting of the energy) permits the definition of: of going and returning of the energy site of its continuation.

• Understanding the “hard” a n d “ s o f t ” of the emptiness and fullness allows the practice of tonification and dispersion. Therefore,

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the

Jiao and Ben of the 6 channels (3 Yin and 3 Yang)

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permits assurance of no longer allowing uncertainty to remain about this world.”

EXPLANATIONS AND COMMENTARIES I - Ma Shi explains: “This paragraph speaks on Jiao (summit) and Ben (root), Ying (Rong: nutritive energy) and Wei (defensive energy), Zang (organs) and Fu (bowels) whose clinical examination is often difficult. But once the examination has been well-performed, there must no longer exist any doubt about the treatment of illnesses. 1 - Man has 5 organs thanks to which Jing (quintessence), Shen (mental), Hun (vegetative soul) and Po (sensitive soul) have their site of conservation. Man has 6 bowels thanks to which the Shui Gu (Cereal-Water: foods) are metabolized. The 6 bowels represent the exterior (Yang). In the interior, their energy is linked to the 5 organs, and at the exterior, it reaches the articulations. 61. Man is equipped with the Sanjiao (SJ). Tong Qi (a priori energy: ancestral energy) is conserved within the Shangjiao (Upper Jiao = UJ); Ying Qi (nutritive energy) becomes released at the level of the Zhongjiao (Middle Jiao = MJ) and Wei Qi (defensive energy) becomes manifest at the Xiajiao (Lower Jiao = LJ). The energy of the Xiajiao (LJ) goes back up to the Zhongjiao (MJ) and arrives at the Shangjiao (UJ) in order to elaborate, with the Tong Qi (a priori energy), all the activities of the organism.

2 - Wei Qi (defensive energy), elaborated at the level of the Xiajiao (LJ = Ki/Li), responds to Yang. Of volatile and powerful nature, it spreads into the epidermo-dermal spaces, that is to say, it emerges at the exterior. This is why, the text makes clear: “The energy emerging at the exterior and not following the paths of the channels is the Wei Qi.” Ying Qi (nutritive energy), elaborated at the level of the Zhongjiao (MJ = Sp/St), is Yin. Of subtle and specific nature, it follows the Tong Qi (a priori energy) in order to circulate within the channels. Thi is why it is said: “ The energy which circulates exclusively within the channels is the Ying Qi.”

3 - Wei energy circulates during the day in the zones of the 3 Yang, and at night, in the zones of the 3 Yin. By contrast, Ying energy circulates, from the lung, within the 12 channels. In this manner, the Yin energy and Yang energy follow each other; the interior and the exterior communicate like a pearl necklace without beginning or end. These perpetual movements are complex, coherent and clear and their analysis merits being delved into deeply. If the channels are regrouped into Yin and Yang, it is that they all have their Peak/Root and their Empty/Fullness. For this reason, discerning the channels of the foot and hand is to know: _ the site of manifestation of the illness _ the state of emptiness and fullness of the channels _ the superficial or deep localization of the illness _ the paths of going and returning (Qi Jie) of the energy of the 6 bowels _ the “doors” and “windows” and paths of liason of the energy _ the “soft” state of emptiness and the “hard” state of fullness in order to apply the appropriate methods of tonification and dispersion.

All these precise conditions are based on the knowledge of Jiao-Ben (Peak-Root) of the 6 channels (3 Yin and 3 Yang). If the knowledge truly reached such a level, not any doubt can survive in the

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human being.” II - Zhang Shi comments:

62.

“1 - This paragraph concerns the circulation of Ying Qi within the channels and that of Wei Qi outside the channels. However, the energy and blood situated in the epidermo-dermal and interchannel spaces enter and exit from exterior toward interior and from interior toward exterior. Yin energy and Yang energy communicate and their movements are cyclic like in a circle without end. Here, the word “Qi” designates Ying (nutritive energy) and Wei (defensive energy) originating from the metabolism of Shui Ge (Cereals-Water). In the interior, this Qi (energy) cools down the 5 organs and maintains the Jing (quintessence), Shen (mental), Hun (vegetative soul) and Po (sensitive soul); at the exterior, it goes to the level of the limbs and articulations to moisten the muscles and bones. In conclusion, this paragraph is devoted to the study of the Organs/Bowels and the 12 Yin and Yang channels circulating from the interior toward the exterior and from the exterior toward the interior. 2 - The term Wei Qi utilized in the title of this chapter implies the sense of extravasation of the Ying energy via the path of Qi Jie (path of going and returning, of entering and exiting) of the energy of the 6 bowels in order to unite with the Wei energy and the sense of circulating during the day in the Yang parts and during the night in the Yin parts of the body. The Ying energy (circulating in the channels) and Wei energy (circulating outside the channels) are invisible energetic substances. In contrast, blood, originating from the transformation of the Shui-Ge (CerealWater) and circulating within the Mai (vessels) and Luo (capillaries) at the level of the epidermo-dermal system, is a material and visible substance and also carries the name of Rong (substance which maintains life). The part of the blood which gives fullness to the skin and flesh and which warms the muscles and bones originates from: _ either the path of the Chongmai (“sea of blood vessels”) in order to spread to the pilo-cutaneous system, _ or the path of Da Luo (Great Luo) in order to extravasate outside the channels. This part of the blood is also called Rong (Ying). This is why our old masters give it the name Rong (Ying), and to its energy, the name Rong (Ying) Qi.”

III - N.V.N.:

Qi Jie designates the routes of passage, entering and exiting, going and returning, of the energy of the 6 bowels (3 Yang: Taiyang, Shaoyang, Yangming). Example: Wuli (LI 13) and Qichong (St 30) (1) are of the Qi Jie of Yangming. Knowledge of Qi Jie permits more easy solution of problems of accumulation/gathering due to the blockage of the movements of leaving of the energy from the Yang channels toward the exterior (to maintain the skin, pores, ...) and of the movements of entering from the exterior toward the channels. All the ideas cited in this passage are dealt with in this classic. Also, it is necessary to not be content with vague and general knowledge, to be compelled to delve deeply into the totality of the chapters of the Lingshu and to be devoted to analysis of the slightest details.

1. Qichong (St 30) also bears the name Qi Jie.

PARAGRAPH

2

63.

Qi Bo:

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“Your

presentation

is

vast

and

imposing!

Your topic permits submission to His Majesty its knowledge according to the following order: _ Ben (root) of the Foot Taiyang (Bl) is located 5 cun above the talus bone, and Jiao (summit), at the level of the 2 Luo (vessels) of M i n g m e n ; here Mingmen designates the eye. _ Ben (root) of the Foot Shaoyang (GB) is located at the point Qiaoyin (GB 44), and Jiao (summit), in front of Zong Long ; here, Zong Long designate the ear. _ Ben (root) of the Foot Shaoyin (Ki) is located 3 cun above the internal malleolus, and Jiao (summit), at Bei Shu (back Shu) and at the 2 sublingual vessels. _ Ben (root) of the Foot Jueyin (Li) is located 5 cun from Xingjian (Li 2), and Jiao (summit), at Bei Shu (back Shu) . _ Ben (root) of the Foot Yangming (St) is located at Lidui (St 45), and Jiao (summit), at the point Renying (St 9) in liason with Xing Zang (maxillary sinus). _ Ben (root) of the Foot Taiyin (Sp) is located 4 cun above and in front of the point Zhongfeng (Li 4), and Jiao (summit), at Bei Shu and at the base of the tongue.” EXPLANATIONS AND COMMENTARIES I - Ma Shi explains:

“This paragraph concerns the Jiao-Ben (Roots-Summits) of the 6 channels of the foot. 1. Ben (root) of the Foot Taiyang (Bl), located 5 cun above the talus (or 3 cun above the external malleolus), is Fuyang (Bl 59), and Jiao (peak), at the 2 Luo of Mingmen (eye),that is to say, at the point Jingmen (Bl 1) left and right, hence the designation 2 Luo (vessels). 2. Ben (root) of the Foot Shaoyang (GB) is located at the point Qiaoyin (GB 44), and Jiao (peak) is found in front of Zong Long (ear), that is to say, at the point Tinghui (GB 2). 3. Ben (root) of the Foot Shaoyin (Ki) is located 3 cun above the internal malleolus, that is to say, at the point Jiaoxin (Ki 8); and Jiao (peak) occurs at Shenshu (Bl 23) and at the sublingual vessels, that is to say, at the point Lianquan (CV 23). 64. 4. Ben (root) of the Foot Jueyin (Li), located 5 cun above the point Xianjian (Li 2), is the point Zhongfeng (Li 4), and Jiao (peak), located on the back, is the point Ganshu (Bl 18). 5. Ben (root) of the Foot Yangming (St) is located at the point Lidui (St 45), and Jiao (peak) is found at Renying (St 9) which sends a vessel to Xing Zang (maxillary sinus). 6. Ben (root) of the Foot Taiyin (Sp) is located 4 cun above the point Zhongfeng (Li 4), that is to say, at the point Sanyinjiao (Sp 6), and Jiao (peak) is found on the back, that is to say, at the point Pishu (Bl 20).”

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II - N.V.N.:

1. “2 Luo of Mingmen”: “2 Luo” designates the 2 Jingmen (Bl 1) points and “Mingmen”, the kidney. Above, this latter communicates with the eyes. This is why the eyes are called Mingmen (door of life). 2. “Jia Xia Xing Zang” (2) designates the maxillary sinus. According to Zhong Shi, Renying (St 9) possesses vessels which communicate with the maxillary sinus and frontal sinus. In the event of disorder, it causes a nasal obstruction or rhinorrhea. We present the following table of Ben/Jiao (Roots-Peaks) of the 6 channels of the foot:

“Ben” Zones (Roots)

“Jiao” Zones (Summits)

1 - Foot Taiyang (Bl)

Fuyang (Bl 59)

Jingming (Bl 1)

2 - Foot Shaoyang (GB)

Qiaoyin (GB 44)

Tinghui (GB 2)

Channels

3 - Foot Shaoyin (Ki) 4 - Foot Jueyin (Li) 5 - Foot Yangming (St)

6 - Foot Taiyin (Sp)

Jiaoxin (Ki 8) Zhongfeng (Li 4) Lidui (St 45)

Sanyinjiao (Sp 6)

Shenshu (Bl 23) Lianquan (CV 23) ---> base of tongue Ganshu (Bl 18) Renying (St 9) ---> maxillary sinus Pishu (Bl 20) Lianquan (CV 23) ---> lips and tongue

Notes: a - Lianquan (CV 23) emits vessels towards the tongue and lips. b - Renying (St 9) possesses vessels which reach the maxillary sinus (Figure 1).

2. See also the explanation in Chapter 5 of the Lingshu (“Origin and Gathering”) , Volume I, NVN Edition. 65.

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Figure 1 The point Renying (St 9) and its branches rising to the maxillary and frontal sinuses.

PARAGRAPH 3 “ Ben (root) of the Hand Taiyang (SI) is located behind the styloid apophysis of the cuboid, and Jiao (peak) is found 1 cun above Mingmen.

Ben (root) of Hand Shaoyang (SJ) is located 2 cun in front of the angle formed by the 4th and 5th metacarpal, and Jiao (peak) is found above and behind the ear

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and at the external tip of the eyebrow.

Ben (root) of the Hand Yangming (LI) located in the middle of the elbow bone extends to “Bie Yang” (distinct Yang), and Jiao (peak) is found at Ren Xia close to Gan Shang. Ben (root) of the Hand Taiyin (Lu) is located at the interior of Cun Kou (radial pulse), and Jiao (peak) is found at the level where the artery beats. Ben (root) of the Hand Shaoyin (He) is located at the tip of the styloid apophysis, and Jiao (peak) is found at Bei Shu (back Shu). Ben (root) of the Hand Jueyin (XB) is located 2 cun behind the wrist between the 2 tendons, and Jiao (peak) is found 3 cun below the axilla.” EXPLANATIONS AND COMMENTARIES

66.

I - Ma Shi explains:

“This paragraph broaches the problem of Jiao/Ben (peak/root) of the 6 channels of the hand. 1 - Ben (root) of the Hand Taiyang (SI), located behind the styloid apophysis of the cuboid, designates the point Yangliao (SI 6), and Jiao (peak), located 1 cun above Mingmen, it seems, is the point Xuanshu (GV 5) belonging to the Dumai, located below the spinal apophysis of L1 (3). 2 - Ben (root) of Hand Shaoyang (SJ), located 2 cun in front of the angle formed by the 4th and 5th metacarpal, is the point Yemen (SJ 2), and Jiao (peak), located at the external edge of the eyebrow, is the point Sizhuikong (SJ 23). 3 - Ben (root) of the Hand Yangming (LI), located at the middle of the elbow bone, is the point Quchi (LI 11) extending to Bie Yang (distinct Yang) (4), and Jiao (root) is located at Ran Xia, that is to say, at the point Tianding (LI 17) uniting with Jian Shang, that is to say, at the point Touwei (St 8). 4 - Ben (root) of the Hand Taiyin (Lu), located at Cun Kou (radial pulse), designates the point Taoyuan (Lu 9), and Jiao (peak), located at the level where the artery beats, designates the point Tianfu (Lu 3).

3. See N.V.N. commentary (1.) below. 4. See N.V.N. explanation (3.) below.

5 - Ben (root) of the Hand Shaoyin (He), located at the tip of the styloid apophysis, is the point Shenmen (He 7), and Jiao (peak), located on the back, is the point Shenshu (Bl 15). 6 - Ben (root) of the Hand Jueyin (XB), located between the 2 tendons behind the wrist, is Neiguan (XB 6), and Jiao (peak), located 3 cun above the axilla and 1 cun outside the place of the breast, is the point Tianchi (XB 1).

II - N.V.N.: The designation of certain points, Jiao (peak), of the 6 channels of the hand has arisen in the course of

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the centuries from numerous discussions and controversies. It merits clarification. 1 - Jiao (peak) of the Hand Taiyang (SI), located 1 cun above Mingmen, does not designate the point Xuanshu (GV 5), but instead the point located 1 cun above Jingmen (Bl 1) because, according to Zhang Jing Yue (1563-1640 A.D.), Jingmen (Bl 1) is the site of reunion-gathering of the Foot and Hand Taiyang (SI + Bl). 2 - Jiao (peak) of the Hand Shaoyang (SJ) occurs above and behind the ear and at the external edge of the eyebrow. This phrase implies that there are 2 Jiao (peak) points. But Ma Shi indicates only one because 67. _ the point located above the auricular apex inside the scalp line is Jiaosun (SJ 20), _ and the point located at the external edge of the eyebrow is Sizhuikong (SJ 23). 3 - “Bie Yang” (Distinct Yang): According to Yang Shang Zian, the Hand Yangming (LI) begins behind the ungual angle of the radial side of the index finger, passes to the elbow, reaches the point Binao (LI 14) called Bie Yang because Binao (LI 14) is the site of reunion-gathering of the Hand Yangming (LI) with the 3 channels: Hand and Foot Taiyang (SI + Bl) and Yangwei. But the Chinese Medical Dictionary (p. 1187) speaks of the point Yangchi (SJ 4). In our opinion, Hand Yangming (LI) passes to the point Binao (LI 14) in order to reach the shoulder at the point Jianyu (LI 15) where it emits a distinct Yang vessel, that is to say, the distinct channel of Hand Yangming (LI) (Figure 2).

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Figure 2: “Bie Yang” (Distinct Yang) and the Hand Yangming (LI).

68.

We present the following table of Jiao/Ben (peaks/roots) of the 3 Yang channels and 3 Yin channels of the hand.

Hand Channels 1 - Hand Taiyang (SI)

“Ben” Zones (Roots)

“Jiao” Zones ( Peaks)

Yangliao (SI 6)

1 cun above Jingming (Bl 1)

2 - Hand Shaoyang (GB)

Yemen (SJ 2)

Jiaoxin (SJ 20) and Sizhuikong (SJ 23)

3 - Hand Yangming (LI)

Quchi (LI 11)

Touwei (St 8)

4 - Hand Taiyin (Lu)

Taiyuan (Lu 9)

Tianfu (Lu 3)

5 - Hand Shaoyin (He)

Shenmen (He 7)

Shenshu (Bl 15)

6 - Hand Jueyin (XB)

Neiguan (XB 6)

Tianchi (XB 1)

PARAGRAPH

4 “In

general,

during

examination

of

the

above-cited

channels,

_ if there is emptiness of the lower part ( B e n / R o o t ), it concerns the illness Afflux (Jue); in contrast, if the lower part is in fullness, it is the sign revealing the illness of Heat (Re). _ if there is emptiness of the upper part ( J i a o / P e a k ), dizziness is noted; in contrast, if the upper part is in fullness, it is the indicator of a painful syndrome with fever.

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This is why, in the event of fullness, it is necessary to use the dispersion method to eliminate the perverse energy, and in the event of emptiness, the method of tonification to augment the source energy (Yuan Qi).”

EXPLANATIONS AND COMMENTARIES I - Ma Shi explains:

“This paragraph speaks on the therapeutic methods of the Root-Peak (Jiao-Ben) of the 12 channels. a - In general, examination of the lower part of the channels of the hand and foot concern the Root (Ben). _ when the Root (Ben) is in emptiness, it is a matter of Afflux (Jue). _ when the Root (Ben) is in fullness, it is a matter of Heat (Re). 69. b - Examination of the upper part of the channels of the foot and hand concern the Peak (Jiao). _ when the Peak (Jiao) is in emptiness, it is a matter of vertigo and dizziness. _ when the Peak (Jiao) is in fullness, it is a matter of a painful syndrome with fever. For this reason, in the event of fullness, it is advised to disperse the perverse energy to obtain cure; and in the event of emptiness, it is advised to tonify the essential energy to augment its potential.”

II - N.V.N.: Zhang Jing Yue provides the following points: “The Jiao-Ben (Peaks-Roots) parts of the 12 channels have their own distinctive pathologic manifestations. The lower part of the channel is called Ben (root). When Ben (root) is in emptiness, it causes an energetic afflux toward the top. In this case, Yuan Yang (Yang source) is weakened below. The upper part of the channel is called Jiao (peak). When Jiao (peak) is in emptiness, it causes vertigo and dizziness. In that case, the pure Yang energy remains down below. As for the fullness of the upper or lower part of the channel, it is due to the presence of heat which overheats them.”

PARAGRAPH 5

“Permit me to complete my dissertation on Qi Jie (site of passage, of entering and exiting, of gathering and concentration of the energy). The The The The

thorax has its Qi Jie . abdomen has its Qi Jie . head has its Qi Jie . limbs have their Qi Jie .

This is why, _ the energy of the head gathers at the brain _ the energy of the thorax gathers at the anterior part of the thorax and at

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Ben Shui (back Shu) _ the energy of the abdomen also gathers at Bei Shu (back Shu) and at the level of the arteries located 2 cun from the umbilicus, at the left and right, _ the energy of the leg gathers at Qichong (St 30- Qi Jie) at the level of the groin and at Chengshan (Bl 57) above the malleoli in the space separating the 2 muscles of the calf. 70.

Using the “Hao” (#7) type needles to puncture the above-cited points. Before needling, it is necessary to press for a long time on the point and await the arrival of a reactive movement under the finger. These points treat the following syndromes: headache, vertigo, syncope, abdominal pains, gastric fullness, marked intumescence, acute energetic accumulation... . Accumulation (Ji) with movement of the pain is curable; in contrast, accumulation without pain is difficult to treat.”

EXPLANATIONS AND COMMENTARIES I -Zhang Shi explains:

“ 1- At the head and thorax, the 12 channels manifest at Qi Jie, sites formed by the paths of conduction of the energy and blood leaving from the lower part (of the channel) toward the Jiao (peaks) of the upper part (of the channels). 2 - Chongmai, “sea” of channels, moistens the Xi Gu (valleys and little valleys: flesh spaces). Along with the Yangming, it unties with the Sun Gan (energetic capillaries and muscular fibers). Therefore, _ the Yin and Yang channels, whose Yangming (St) is the head of the line, are all under the dependence of the Daimai (belt vessel) attached to the Dumai (GV). _ blood and energy, via the path of the Chongmai, reach Qi Jie of the abdomen, that is to say, the point Qichong (St 30- other name Qi Jie), and gather at the level of the arteries situated to the left and right of the umbilicus. According to Tian Dong Shu, the Chongmai, coming from the kidney organ, emits a vessel which descends to Qi Jie (St 30, other name Qichong), reaches the internal part of the groin, descends to the popliteal crease belonging to the Foot Taiyang (Bl). Via this route, the Chongmai unites with Chengshan (Bl 57) located above the malleoli, that is to say, at the calf. This description concerns the Foot Shaoyin (Ki) which, with the Chongmai, manifests at the level of the Qi Jie of the leg. 3 - Shaoyin (Ki) and Yangming (St) are the sites of the start of the production of blood and energy. The obstruction of Qi Jie of the leg prevents the circulation of blood and energy of the Shaoyin (Ki) toward the top, hence headache and vertigo. The obstruction of Qi Jie of the abdomen hinders the spreading of blood and energy, hence abdominal pain, gastric fullness ... . Such are the phenomena know as Jue Ni (contrary afflux) of the energy of Shaoyin (Ki) and Yangming (St) whose treatment consists of utilizing the “Hao” (#7) type of needle. 71.

4 - In this paragraph, the syndrome of accumulation (Ji) is taken as an example to explain the exit of Ying-Blood outside the Jingluo at the level of Qi Jie in order to unite with Wei Qi (defensive energy) to affect a circulation “without end or beginning”.

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The illnesses cited above all originate either from disturbance of the blood or disturbance of the energy, two essential ideas which must always be present in the mind of the physician.”

II - Ma Shi comments:

“This paragraph emphasizes the existence of Qi Jie, sites of stoppage of the energy which must be known to discern if one is to correctly practice acupuncture. Jie is a path of stoppage and departing, because _ the energy, directed toward the head, stops at the brain _ the energy, directed toward the thorax, stops at the hypochondria and Bei Shu (back Shu) _ the energy, directed toward the abdomen, stops at Bei Shu and at the anterior part of the body at the level of the Chongmai-Renmai (CV) and Foot Yangming (St) and at the level of the arteries located to the left and right of the umbilicus (that is to say, at the point Tianshu- St 25). _ the energy circulating in the leg stops at Qi Jie, also named Qichong (St 30), belonging to the Foot Yangming (St), and at the point Chengshan (Bl 57), belonging to the Foot Taiyang (Bl), as the points located above and outside the malleoli. At the time of needling these Si Jie (4 “Jie” zones noted above), it is advised to use the Hao type needle to treat headaches, vertigo, abdominal bloating, gastric fullness, acute accumulation“.

III - N.V.N.: 1 - “Qi Jie”, fundamental notion of the practice of acupuncture, merits being analyzed and delved into deeply according to contemporary thought. “Qie Ji” designates the path of gathering of the energy, that is to say, the path of exit of Ying (nutritive) energy outside the channels at the ends in order to unite with the Wei (defensive) energy and spread into all levels of the body. Each part of the body consists of its Qi Jie and therapy also understood from the appropriate methods for each case. Therefore, _ in order to curb the illnesses caused by the energy of the head, the specific point of the brain is used, Baihui (GV 20). _ in order to curb the illnesses caused by the energy of the thorax, the specific points located at the superior part of the ribcage (Mu points located on the thorax) and Bei Shu (back Shu) points located to the side of the spine between T7 and T2 are used. _ in order to curb the illnesses caused by the energy of the abdomen, the Bei Shu (back Shu) points, located in the trajectory of the Foot Taiyang (Bl), and the points located at the arteries of the 2 sides of the umbilicus, Huanshu (Ki 16) and Tianshu (St 25), are used. _ in order to curb the illnesses caused by the energy of the leg, the pointQichong (St 30), located at the internal side of the crural artery in the fold of the groin, and the point Chengshan (Bl 57), located at the calf, are used.

2 - Interesting points by Zhang Jing Yue in this connection include: “This paragraph concerns the areas of gathering of the energy (Qi Jie), while the preceding paragraphs speak on the Peak (Jiao) and Root (Ben) of the 12 channels. The marrows belong to the brain whose most elevated place has the name “Qi Jie of the cranium”. Here, the 2 sides of the thorax designate the areas belonging to the Foot Yangming (St) and Foot Shaoyin (Ki). On the back, the energy circulating at the level of Bei Shu (back Shu) of the organs and bowels, located to the side of the spine between T2 and S2,, are the Qi Jie of the thorax and abdomen.

At the abdomen, the Qi Jie are formed at the Chongmai associated with the Foot Shaoyin (Ki) and at the

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peri-umbilical arteries (Ex: Huangshu- Ki 16 and Tianshu- St 25). At the calf, the Qi Jie are formed at the level of the point Chengshan (Bl 57) and at the level of the point Qichong (also named Qi Jie- St 30), site of gathering of the Chongmai and Foot Yangming (St). • The points cited above treat illnesses of the paths of gathering of the energy (Qi Jie), among which one distinguishes acute accumulation and chronic accumulation. The acute accumulation is without form and manifests by pains. This state indicates the presence of the energy; for this reason, the illness is easy to cure. In contrast, the chronic accumulation is indolent and always endowed with a form. It is the indicator of the absence of energy; the illness is very difficult to treat.”

3 - We present below a diagram of the Qi Jie of the leg and another at the level of the peri-umbilical arteries.

73.

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Figure 3: Qi Jie at the level of the lower limb: Qichong (St 30) and Chengshan (Bl 57).

Figure 4: Qi Jie at the level of the peri-umbilical arteries: Huangshu (Ki 16) and Tianshu (St 25). no 74/75.

CHAPTER

LIII

Discussion on Pain (Lun Tong)

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Chapter 53 of the Lingshu contrasts two opposing abilities to resist pain and toxins. It explains the marked resistance to pain provoked by acupuncture and moxabustion in individuals provided with a flexible musculature, and weak resistance in individuals having thin skin and firm musculature. Individuals endowed with thick skin, blackish color, large bones and solid and plump organs more easily resist toxic medicines than thin individuals with a weak stomach. The objective of this chapter then is to discourse on the endurance to iatrogenic pain, hence the title: “Discussion on Pain” (Lun Tong). Ma Shi emphasizes: “The contents of this chapter 53 of the Lingshu speaks on the ability or inability to endure the pain of the needles (acupuncture), the points of stone (lithopuncture), fire (moxabustion) and heat (heated needles), hence the title of the chapter”. This chapter is composed of 2 paragraphs.

PARAGRAPH 1 Huangdi questions Shao Yu: “The solidness and weakness of the tendons and bones, the firmness and flexibility of the flesh, the thickness and thinness of the skin, the watertightness and permeability of the pores are variable. As a result, what are their reactions to pain provokes by the needles (acupuncture), by the points of stone (lithopuncture), by fire (moxa) and by heat (heated needles)? 76.

Similarly, the thickness and thinness of the skin, the firmness and weakness of the stomach and intestines are also variable. What are their reactions to toxic medicines? I would like you to explain this to me.” Shao

Yu replies: “Individuals endowed with solid bones, supple tendons, soft, moist flesh and thick skin can endure the pain provoked by needles, points of stone, fire (moxabustion) and heat (heated needles).” Huangdi: “How do you recognize those who can endure pain caused by fire (moxabustion) and by heat (heated needles)?” Shao

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Yu: “Individuals of black color and powerful bones can tolerate fire and heat.”

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Huangdi: “How do you recognize those who cannot tolerate pain provoked by the needles (acupuncture) and the points of stone (lithopuncture)?” Shao

Yu: “Individuals of firm musculature and thin skin cannot endure the pain of needles and points of stone and, naturally, the pain of fire (moxabustion) and heat (heated needles).”

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains: “1 - Skin, flesh, muscles, tendons and bones are dependent on the “production/ maintenance” of the Shaoyin (Ki) and Yangming (St). The Shaoyin (Ki) possesses the vital energy (Sheng Qi) of the natural world, and the Yangming (St) transforms the Shui Gu (Water-Cereals) into food Jing. As a result, the solidness and weakness of the tendons and bones. the firmness or softness of the flesh (dermis), the thickness and thinness of the skin (epidermis), the density and dispersion of the sweat glands... depend on the energetic state of these two channels.

2 - Black color and good bones originate from the plethoric state of the blood and energy of Shaoyin (Ki). The blossoming of the flesh results from the plethoric state of the blood and energy of Yangming (St).” 77.

II - N.V.N.: In October, 1971, based on this chapter 53 and chapters concerning the Jingluo (principal and secondary channels), particularly the Jing Jin (tendinomuscular channels) of this classic, we performed for the first time in the West the removal of a hand cyst and an inguinal hernia (1) by acupuncture analgesia which, at the time, was entered into the history of Western Medicine. Our job in this era should consist of demonstrating the reality of Acupuncture (2) on the one hand, and, on the other hand, the existence of energy in the human body (3) via clinical facts. But flawless mastery of the points and channels is not sufficient to make acupuncture progress. It is also necessary to deepen the notions of Jing, Qi, Shen and Sanjiao (Quintessence, Energy, Mental and Three Jiao) to better comprehend the etio-patho-physiologic processes of Energetic Medicine.

PARAGRAPH 2 Huangdi: “How do you recognize those who cannot resist toxic substances?” Shao

Yu: “Individuals whose stomach is thick, color black, body fat, tolerate toxic products well. In contrast, thin individuals, whose gastric wall is thin, poorly tolerate toxic substances.”

EXPLANATIONS AND COMMENTARIES

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I - Zhang Shi explains:

“This paragraph gives discourse on the association of the energy of Shaoyin (Ki) and that of Yangming (St). The Yangming (St), located at the Earth-Center part, governs the reception of Shui Gu (Water-Cereals) thanks to the ascending energy of Shaoyin (Ki). In other words, Wu (5th Celestial Trunk responding to StomachEarth) associates with Gui (10th Celestial Trunk responding to Kidney-Water) in order to metabolize the energy of Fire and Earth which allows the purification of the pure cereal substances. 78.

This is why: _ the thick-walled stomach _ black color _ large bones _ generous body are signs of fullness of the energy of the Shaoyin (Ki) and Yangming (St) which permit resistance to toxic substances.”

1. Without premedication. See “Theory and Practice of Analgesia By Acupuncture”, N.V.N. Edition. 2. Denied by colleagues of the times. 3. “Energy-Matter” theory.

II - N.V.N.: Cartesian-minded acupuncture cannot understand or accept the explanation of Zhang Shi. We must then delve even more deeply into the notions “Jing, Qi, Shen and Sanjiao” if we do not want acupuncture in the West to become simple reflexotherapy.

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79.

CHAPTER LIV Celestial Age (Tian Nian)

Chapter 54 of the Lingshu involves the longevity and brevity of the human being as a function of: _ the emptiness and fullness of blood and energy _ the insufficiency and excess of the 5 organs and 6 bowels _ and the weakness and strength of the bodily form of the individual.

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The physiologic and mental changes of the human being, from birth to death, are also addressed here. “Celestial Age” implies the sense of living according to the rhythym “Heaven-Earth”, that is to say, according to the 60 year cycle. For the classics, the heavenly age is equivalent to 100 years. The key point of this chapter is to advance the conservation of the good health of Eugenism (Ye Sheng). Ma Shi emphasizes: “This chapter 54 discourses on centenarians, hence the title of this chapter.” This chapter is composed of 6 paragraphs.

PARAGRAPH 1 Huangdi: “I would like you to inform me about fertilization. What is the energy that constitutes the foundation (base) and what is the energy that serves as shield (protection)? 80. What is the loss that causes man to die, and what is the gain that prolongs his life?” Qi Bo:

“Mother is the f o u n d a t i o n , and father, the s h i e l d . To lose the Shen (Mental) is death; to hold the Shen is life.”

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains:

“According to Yi Chong Chi, this chapter speaks on life and death, longevity and brevity, which depends entirely on the energy of the Shaoyin (Ki) (1) and that of Yangming (St) (2). • Yang designates father and Yin, mother. This means to say that man is born thanks to the energy of the Shaoyin (Ki). • Shield is a defensive armour, thick plate carried in the left arm by warriors to protect against the enemy. That means to say that the energy of Yangming (St) is indispensible in the formation of the fetus. • The union of the 2 Jing (sexual: ovum and sperm) originating from the parents form the Shen (mental). In other words, it is due to the sufficiency of these 2 Jing that later creates Xing (form) and Shen (mental) and that man can live up to 100 years.”

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II - Ma Shi comments:

“This paragraph studies the cause of life and death. According to the principle of Kun , principle of creation of all things, at fertilization the mother serves as “foundation” destined to insure the stability of an elaboration, and the father as “shield”, that is to say, the Yang energy to protect. This is why to lose the Shen (mental energy) supplied by the parents means death and to conserve it means life.”

III - N.V.N.: Regarding the formation of the fetus, Zhang Jing Yue writes: “The father is rich in Yang energy from the principle Qian , and the mother, rich in Yin energy from the principle Kun . Yang is designated by one line ( ), hence the role of distribution. Yin has two lines ( ), hence the role of reception. This is why mother (Yin) is called “foundation” (base) and father, “shield” (circle of protection).” 1. The kidney is source organ of Yin and Yang, producer of sexual Jing (egg, sperm). 2. The stomach and spleen respond to Earth, therefore to form (Xing).

PARAGRAPH 2

81.

Huangdi: “What does Shen (mental) r e p r e s e n t ? ” Qi Bo:

“When Qi (energy) and Xue (blood) are balanced, Ying (Rong: nutritive e n e r g y ) and Wei (defensive energy) freely circulate. The 5 organs being formed, Shen (mental energy) resides in the heart, Hun (vegetative soul) and Po (sensitive soul) are complete. All these components contribute to the formation of the human being.” EXPLANATIONS AND COMMENTARIES I - Zhang Shu explains:

“This paragraph speaks about the fact that at birth, thanks to the Jing Qi of the parents, the Qi Xue (energy-blood) and Shen Chen (mental-will) of the 5 organs can be formed, indispensible elements to create the human being.” II - N.V.N.: 1. Shen (mental) is the fundamental and original notion of Traditional Chinese Medicine. It represents the force of the vital activity of man. It is received within the heart; the heart then is essential to life, the sourcesite of the mental force. Because, when the heart is calm, the Shen is awake, and when the heart is agitated, the Shen is disturbed. The term “Hun-Po” (vegetative soul-sensitive soul) designates the activities of the Jing-Shen (pure energy/mental) of the human being, and Jing-Shen, the phase of maturity of the Shen, is characterized by the presence of consciousness and by the sense of responsibility for the energetic activity of

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the organs. 2. Jing is always associated with Shen. In this manner, the Jing-Shen of the 5 organs are defined in the following fashion: a - For the Liver: _ anatomic Jing maintains the tendons and muscles _ sensorial Jing, the eyes (visual acuity) _ psychologic Jing, the Hun (vegetative soul) _ energetic Jing, Ministerial Fire (3). b _ _ _ _

- For the Heart: anatomic Jing maintains the blood and vessels sensorial Jing, the tongue (voice, speech) psychologic Jing, the Shen (mental) energetic Jing, Imperial Fire (4).

82....

3. Fire which activates the energetic functions of the entire organism via the path of Sanjiao (SJ). 4. Imperial Fire controls Ministerial Fire. 82....

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Figure 1: Jing (quintessence) of the 5 organs.

c - For the Spleen, _ anatomic Jing maintains the flesh (dermis) _ sensorial Jing, the lips (gustation) _ psychologic Jing, the Yi (thought, reflection) _ energetic Jing, the distribution of blood, energy and organic liquids throughout the entire organism. d - For the Lung, 83. _ anatomic Jing maintains the skin and hairs (pilocutaneous system) _ sensorial Jing, the nose (olfaction) _ psychologic Jing, the Po (sensitive soul) _ energetic Jing, the laryngo-pharyngeal apparatus (respiration and digestion). e _ _ _ _ _ _ _

- For the kidney, anatomic Jing maintains the osteo-medullary system sensorial Jing, the ears (audition) psychologic Jing, the Chi (will) sexual Jing, spermatogenesis and ovulation thermic Jing, cold (Yin) and heat (Yang) of the body energetic Jing, Ministerial Fire hereditary Jing (genetic).

These notions are integral parts of the energetic physiology of Traditional Chinese Medicine. The choice of points and therapeutic results depend on this (See Figure 1).

PARAGRAPH 3 Huangdi: “Longevity or brevity of life varies from one individual to another. Some die prematurely, others live a long time and others experience disease. I would like you to speak to me of this problem.” Qi Bo:

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“Longevity results: _ from the solidity and firmness of the 5 organs _ from the regularity of the circulation of blood and vessels _ from the suppleness of the flesh (dermis)

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_ from the watertightness of the skin _ from the harmonious circulation of Ying (nutritive energy) and Wei (defensive energy) _ from the slow and light rhythm of respiration _ from the conformity of the circulation of Qi (energy) _ from the digestive function of the 6 bowels _ and from the perfect distribution of organic liquids throughout the entire organism. Every function follows the normal rules. This is why life can be prolonged.”

EXPLANATI0NS AND COMMENTARIES

84.

I - Ma Shi explains:

“This paragraph speaks of longevity and brevity, life and death, which varies from one individual to another. To know the causes of longevity is to know those of premature death.” II - N.V.N.: Zhang Jing Yue gives the following analysis: “All the organic functions cited in this paragraph are conditioned by the Sanjiao (SJ)”. It is therefore necessary to delve deeply into the energy of the “Xin Bao/Sanjiao” (XB/SJ) system because “without Sanjiao, no life”.

PARAGRAPH 4 Huangdi: “Some individuals live to 100 years. How can they have such a long life?” Qi Bo:

“In individuals who have a long life, _ the nostrils and nasolabial groove (Xu Dao) are deep and long, _ the chin and “facial rampart” (Go Zang) are thick and very square, _ Ying (nutritive energy) and Wei (defensive energy) circulate freely, _ the “3 areas of Sanli” (San Bu San Li) are raised without being depressed, _ the bones are prominent and strong, _ and the flesh is full. With such a form and structure, man can live to 100 years.”

EXPLANATIONS AND COMMENTARIES I - Ma Shi expands:

85.

“The term “Xu Dao” designates the point Renzhong (GV 26) located in the nasolabial groove whose depth and length indicate: _ the thick appearance and very square chin and “rampart” (4 sides of the face) _ and the harmonious circulation of Ying and Wei.

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The term “San Bu San Li” designates the 3 facial areas (San Ding: upper palace, middle palace and lower palace) (see Figure 2) whose thickness denotes the weight of the bones and firmness of flesh. Such are the signs revealing longevity.” II - Zhang Shi comments:

“Man can maintain a longevity of 100 years (heavenly age) thanks to: _ the sufficiency of innate and acquired Jing (quintessence) _ the steady and harmonious circulation of Ying and Wei _ large bone structure _ and the firmness of the flesh. “Xu Dao” designates the nasolabial groove, route of communication of the blood and energy. Chapter 2 of this classic (“Origin of the Shu”) gives it the name Jianshi Chi Dao (route of Jianshi-XB 5) because the Xin Bao Luo (XB) governs the blood and energetic vessels. “Go Zang” designates the chin and the rampart (4 sides of the face). The high rampart denotes the plethoric state of blood and energy, and the very square chin, the very full musculature.

Figure 2 “San Bu” (Three Palaces)

Figure 3 Renzhong (GV 26) and the “7 orifices” 86.

“San Bu” designates the “3 Palaces” (San Ding) of the body, upper, middle and lower (see Figure 2), and “San Li”, the well-balanced energetic state of the Hand and Foot Yangming (LI and St). As a result, a large skeletal structure originates from the rhythmic ease of the Foot Shaoyin (Ki), and a very full flesh, the flourishing state of the Yangming (St). Such are the symbols of longevity.”

III - N.V.N.:

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In relation to Xu Dao, Zhang Jing Yue supplies the following clarifications: “The term Xu Dao (nasolabial groove) implies the sense of the 7 orifices (2 ears, 2 eyes, 2 nostrils, and mouth). This is the site of reunion/communication of Jing (quintessence) of the 5 organs. In this way, _ the Jing of the lung communicates with the nose _ the Jing of the liver, with the eyes _ the Jing of the spleen, with the mouth _ the Jing of the heart, with the tongue _ the Jing of the kidney, with the ears.” The explanation of Zhang Jing Yue permits therefore understanding the reanimating action of the point Renzhong (GV 26). (Figure 3)

PARAGRAPH 5

Huangdi: “Please explain to me the problem of fullness and emptiness of the blood and energy of the human being from childhood to death.” Qi Bo:

“• At 10 years of age, _ the 5 organs begin to strengthen _ blood and energy circulate freely _ the energy is in fullness at the lower part of the body This is why, the little child likes to run and jump. • _ _ _

At 20 years of age, growth is in full maturity blood and energy begin to be flourishing the muscles are at their full phase of development This is why, the individual likes to walk with rapid steps.

• At 30 years of age, 87. _ the 5 organs are completely consolidated and stabilized _ the muscles are solid and firm _ blood and energy are in full richness This is why, the individual likes to walk steady with slow steps. • At 40 years of age, _ the 5 organs/6 bowels and 12 Jingmai are in great fullness and are found in the state of arrested development _ the sweat gland system begins to be sparse _ the hair begins to fall and whiten _ maximal fullness is always followed by a sensation of sluggishness and heaviness. This is why the individual likes to sit. • _ _ _ _

70

At 50 years of age, the energy of the liver begins to decline the “hepatic leaves” (liver organ) begin to thin the bile, to become reduced and visual acutiy, to diminish.

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• At 60 years of age, _ the energy of the heart begins to grow weak _ the individual is often preoccupied and sad _ blood and energy circulate nonchalantly. This is why the individual likes to lie down. • At 70 years of age, _The energy of rage begins to diminish _ the skin withers and dries out.

• At 80 years of age, _ the energy of the lung grows weaker _ the Hun (vegetative soul) and Po (sensitive soul) separate. This is why speech is often confused. • At 90 years of age, _ the energy of the kidney runs dry _ the Jingmai of the other 4 organs are in insufficiency. • And at the age of 100 years, _ the 5 organs are completely in insufficiency _ Shen Qi (mental energy) has disappeared. There remains only the bodily form which waits for death.”

EXPLANATIONS AND COMMENTARIES I - Zhang Shi describes:

“This paragraph speaks about the birth and growth of the human being. The energy is born at the bottom and evolves toward the top. This is why it is said: “When the energy is still located at the lower part of the body, the child walks with rapid steps”, which responds to the energy of the birth of spring and the active energy of summer. 88. In contrast, at advanced age, the energy evolves from the top downward, from Yang toward Yin. Bodily deficiency starts then by the liver, then the heart, spleen, lung and kidney. “The individual likes to sit and lie down” in order to conform with the energy of the kidney organ and Yangming (St). The insufficiency of the energy of these two organs is the cause of “increased scarcity of the sweat gland system” and of the “hair falling and whitening.” Chi Shi states: “Man is born, then evolves from the Jing of the kidney organ. Wood, Metal and Earth are created from Water and Fire, that is to say, from the “5 Movements a priori”. In old age, deficiency starts via Wood-Liver, then Heart-Fire, Spleen-Earth, Metal-Lung and WaterKidney, that is to say, the “5 Movements a posteriori”.”

II - Ma Shi comments:

“This paragraph speaks about the fact that: _ from 10 to 30 years, man progressively develops

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_ from 50 to 100 years, he begins to gradually decline. To speak of “the energy located at the lower part of the body” is to assure the plethoric state of the energy at the level of the 6 channels of the foot. From 50 years of age, the decline takes effect every 10 years according to the law of the “5 Movements”, beginning by the liver, then the heart, spleen, lung and, finally, the kidney (50 : 5 = 10). That is why: _ at 50 years of age, the energy of the gallbladder declines _ at 60 years, the energy of the heart grows weaker _ at 70 years, the energy of the spleen subsides _ at 80 years, the lung diminishes _ at 90 years, the energy of the kidney becomes exhausted _ at 100 years, the energy of the 5 organs becomes empty.” III - N.V.N.: Chapter 54 of the Lingshu completes Chapter 1 of the Suwen (“9 Needles and 12 Yuan”). The Suwen uses the numbers 7 and 8 to explain the duration of the different evolutive phases of bodily transformation in the female and male, while this chapter of the Lingshu employs the number 10 to explain the duration of the different phases of decline in man from 50 years of age. In relation to old age, recall the question and reply of Huangdi and Qi Bo: 89. “Huangdi questions: _ In old age, one cannot have children; is that due to the exhasution of the Jing or is it the fault of the “heavenly numbers” (Tian Xu)? Qi Bo replies: • In young girls, At 7 years of age, the energy of the kidneys is plentiful, the milk teeth change, the hair lengthens. At the age “two seven” (2 X 7 = 14 years), “Celestial Gui” (Tian Gui) enters into play, the Renmai (CV) circulates abundantly, the Chongmai is prosperous, menses manifests following a determined cycle, the young girl can create. At the age “three seven” (3 X 7 = 21 years), the energy of the kidneys is in fullness, the wisdom teeth finish pushing out. At the age “four seven” (4 X 7 = 28 years), the muscles and bones become solid, the hair reaches its greatest length, the body is more robust. At the age “five seven” (5 X 7 = 35 years), the Yangming (St) energy begins to weaken, vision to fade, the hair to fall. At the age “six seven” (6 X 7 = 42 years), the energy of the 3 Yang grows weaker at the top of the body, the face dries out, the hair whitens. At the age “seven seven” (7 X 7 = 49 years), the Renmai (CV) is empty, the Chongmai grows weaker,“ Celestial Gui” disappears, the “channels of Earth” are obstructed. This is why the body becomes exhausted, the woman is no longer fertile. •In boys, At 8 years of age, the energy of the kidneys becomes asserted, the hair lengthens, the milk teeth change. At the age “two eight” (2 X 8 = 16 years), the energy of the kidney is plentiful, “Celestial Gui” appears, Jing overflows, Yin is in harmony with Yang, the boy can inseminate. At the age “three eight” (3 X 8 = 24 years), the energy of the kidneys is in fullness, the muscles and bones become firm and solid, the wisdom teeth finish pushing out. At the age “four eight” (4 X 8 = 32 years), man is robust, skin and flesh are in full bloom. At the age “five eight” (5 X 8 = 40 years), the energy of the kidneys slowly grows weak, the hair falls, the teeth begin to lose their brilliance. At the age “six eight” (6 X 8 = 48 years), the Yang energy wears out at the top of the body, the face fades, the temples gray. At the age “seven eight” (7 X 8 = 56 years), the energy of the liver is empty, the muscles and tendons

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weaken, “Celestial Gui” disappears, Jing diminishes, the kidney organs function poorly, the body is heavy and fatigued. At the age “eight eight” (8 X 8 = 64 years), the teeth and hair are falling out... . 90. • The kidneys correspond to Water. They receive and conserve the Jing of the five organs and 6 bowels. This is why, when these organs and bowels are flourishing, the Jing of the kidneys pours out. If they are weak, the muscles and bones become lax, “Heavenly Gui” disappears. Because of this, the hair and beard whiten, the body becomes heavy, the walk becomes labored, man man can no longer have children.” 1 - The “Celestial Numbers” are numbers which determine the duration of the different evolutive phases of bodily transformation in the male and female. 2 - Woman is Yin or, more exactly, Shaoyin. Shaoyin is the little Yin; it can only be placed into motion, therefore put into life, by the Yang root. Yang, at this stage, is the determining factor. Therefore, a Yang, odd, number, 7, is chosen as the basis for the cyclic evolution of women. 3 - It concerns the Jing (Quintessence) of the kidney. 4 - Gui is the 10th Celestial Stem and corresponds to Water (Kidney). Among the Celestial Stems, Ren, 9th, is Yang and Gui, 10th, is Yin. In the present case, Ren represents the concentration of the energy. that is to say, the movement of Yang going toward Yin (concentration), and Gui represents the manifestation of the energy, that is to say, the movement of Yin toward Yang (manifestation). According to Qi Bo, Celestial Gui is innate. It is reinforced a posteriori by the digestive Jing represented by the sapors/flavors. These reach the spleen first, then are directly conducted to the corresponding organs. Example: sour toward the liver, spicy toward the lung... . In the event of excess Jing within the organs, the kidneys absorb it and conserve it in order to distribute it into the entire body, particularly into marrow and brain. Jing conserved within the kidney reaches the heart via the intermediary of the liver, following the chain of production of the law of the 5 Movements, where it becomes transformed into blood and then reaches the Chongmai and Renmai (CV) to maintain the flesh and act on the roots of the head hair and body hair. This is why, in males, at the time when the vital energy is strong, Celestial Gui becomes transformed into blood and reaches the Chongmai and Renmai (CV) which end up at the chin and lips, hence beard and moustache. In contrast, in young girls, when Celestial Gui arrives, menses appears. In summary, Celestial Gui designates at the same time Jing (quintessence) and blood and not only menses as was supported by the celebrated Wang Bing of the Tang Dynasty (618-907 A.D.). The thesis of Wang Bing did not agree with the spirit of the Suwen: “Menses and sperm are manifestations of Celestial Gui.” 91.

Jing (quintessence) energy of the kidney is then at the same time innate (ancestral energy: Ren and Gui) and acquired (dietary energy: sapor and Ying Qi). In the child, it first spreads into the most essential regions of this age to assure growth and development: bone, marrow, blood (kidney) and muscles, blood (liver) following the chain of production of the 5 Movements. During puberty, the energy is always plethoric (innate and acquired). The need is less great for it to supply growth factors as a matter of priority. A part of this energy is then allocated to the genital organs, to the curious channels on which they depend. At the time of andropause and menopause, hereditary energy sees its potential dwindle. The relay is then progressively assured by the acquired energy of dietary origin. The essential point is the maintenance of life. The energetic potential being limited, it is distributed into vital areas to the detriment of other areas (particularly genital). In this manner, in Oriental spirit, Gui designates at the same time: _ Celestial Stem _ its maintenance _ and its manifestations.

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5 - Renmai (CV) and Chongmai make up part of the group of 8 Curious Channels. They constitute the system of conservation of energy and blood, hence their name “Sea of Energy and Blood”. In gynecology, the Renmai controls uterine functions and the Chongmai oversees the blood (menses). It is only from 14 years of age that these channels communicate. • According to the Lingshu, “The Chongmai and Renmai (CV) begin at the level of the kidney and are the origin of all principal and secondary channels (Jingluo). They immerge from the abdomen and ascend to the throat to arrive at the chin to encircle the lips. In individuals whose blood and energy are in equilibrium, the energy of these two channels spreads and reaches the flesh, warming it up. In individuals whose blood is plethoric, the energy of these two channels reaches the flesh, saturates the skin and gives rise to the body hair. Generally, in women, the energy is strong and blood weak (due to menses). Buccal branches from the Renmai (CV) Chongmai are imperfect, so she has neither moustache nor beard.” • The explanation of the Neijing is extremely important. The notion of Blood/Energy is finally clarified: _ man has more blood than energy, hence moustache and beard _ woman has more energy than blood, hence absence of moustache and beard _ when one speaks of energy and blood, energy is Yang and blood is Yin _ in women (Yin), blood (Yin) weakens more quickly than energy (Yang), while in men, it is the reverse. 92.

6 - The energy of Yangming (LI and St) goes to the face, goes around the skull and irrigates the roots of the hair via the route of the principle and secondary channels of the large intestine and stomach. This is the reason why, when the energy of Yangming is in emptiness, the face fades and the head hair falls out. The Foot Yangming (St) has a very important relationship with the two Curious Channels, Renmai (CV) and Chongmai. It receives very numerous branches from these two channels at the level of the point Tianshu (St 25). The energy conducted via these Curious Channels is conveyed by the stomach, then reaches the thorax via the secondary channels, in particular the Longitudinal Luo and the Distinct Channel. This relationship explains that when the energy of Renmai (CV) and Chongmai is in emptiness, that of the Yangming (St) is also empty. 7 - The 3 Yang designate Taiyang, Shaoyang and Yangming which are divided into: _ 3 Yang channels of the hand: Hand Taiyang (SI), Hand Shaoyang (SJ), Hand Yangming (LI) _ 3 Yang channels of the foot: Foot Taiyang (Bl), Foot Shaoyang (GB) and Foot Yangming (St). The energy of these channels reaches the head via the route of the secondary channels on the one hand, and globally on the other hand, that is to say, independent of the trajectory of the channels. Also, when their energy grows weak, the face necessarily becomes wrinkled and the hair whitens and falls. 8 - The “channels of Earth” (Ti Dao) designate the channels located at the lower abdomen, particularly the internal vessel of the kidney and “Fuchong” (internal vessel of the Chongmai) (Figure 4). 9 - Males are Shaoyang. This little Yang can only be created and only exist thanks to the Yin Root. Therefore, a Yin, even, number, 8, is chosen as the basis in the cyclic evolution of man (5). 10 - The energy of the liver and energy of the kidney each have very precise functions: _ the energy of the liver maintains the muscles and tendons and controls blood formation _ the kidney energy maintains the bones and marrow and controls energetic function. The liver and kidney then have key relationships because of the Yin-Yang, Water-Fire, Blood-Energy interactions and especially because of the productive chain of the 5 Movements: Water (Kidney) creates Wood (Liver). 5. See explantion no. 2 above, p. 76.

As a consequence, renal insufficiency always causes a series of insufficiencies of the functions of the other organs, particularly the liver (liver is the “son” of kidney).

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11 - In men, Celestial Gui disappears at the age eight-eight” (8 X 8 = 64 years), and in women, at the age “seven-seven” (7 X 7 = 49 years). Such is the approximate duration of the Celestial Gui. But the energy and blood continue to circulate; so, in aged individuals, the bones and muscles remain robust thanks to the good functioning of the energy of the spleen and stomach. In some women whose age exceeds the point “seven-seven” (7 X 7 = 49 years), menses takes a long time to disappear via the presence of blood and energy circulating in the “Satisfying Channels” (Jing Dua) (6) which flood the two Curious Channels, Chongmai and Renmai (CV). In women, the face is yellow, the body dry and thinned; they often complain of bone pains (menopausal rheumatism) and muscular fatigue. Finally, recall that the blood (Ying) belonging to the “satisfying” channels circulates within the channels. The blood (Ying) belonging to the Chongmai and Renmai (CV) spread outside the channels. 93.

Figure 4: Internal vessel of the Chongmai: Fuchong. 6. It concerns channels which have the ability to retain Ying Qi (nutritive energy) for a longer time than normal.

PARAGRAPH 6

94.

Huangdi: “Some individuals do not know longevity and die. Why?”

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Qi Bo:

“In _ _ _ _ _ _ _ _

these

individuals,

the organs lose their firmness, the nasolabial groove is short, the nostrils are dilated toward the exterior, respiration is asthmatic and rapid, the chin ( G e ) is shortened, facial shape (“rampart”, Zang) is thinned down, blood is lacking within the vessels the muscles are not firm.

Moreover, they are easily open to attack of Feng-Han ( W i n d - C o l d ) which: _ further weakens the blood and energy _ impedes the routes of the Jingmai _ causes a battle against the source energy ( Yuan Qi, original or vital energy). Because Yuan Qi grows weaker, the perverse energy progresses deeply toward the interior and provokes perturbations in the organism. This is why the individual can only live to “middle age (Zhong Zo)” . ”

EXPLANATIONS AND COMMENTARIES I - Zhang Shi clarifies:

“This paragraph explains the fact that in man, receiving in innate fashion a deficient a priori energy, the a posteriori energy can help to strengthen it. If, moreover, he takes care to avoid the Pirate-Wind and Empty-Perverse Energy, he can hope to live a long time. In contrast, if the innate energy is weak and if he ignores the rules of nutrition with frequent attack by Feng-Han (Wind-Cold), the individual will have a premature death without being able to attain old age. The phrases “The organs lack firmness, Xu Dao (nasolabial groove) is short, etc.” gives all evidence of insufficiency of the a priori energy. Similarly, thinness of the foundation of the “rampart” (facial contour), the blood shortage within the vessels, muscle weakness, etc., are due to poor observance of the rules of nutrition which permits the Empty-Perverse Energy and Pirate-Wind to penetrate deeply into the organism, provoking a confrontation between the essential energy (Source Energy, Yuan Qi = Jing) and perverse energy, hence premature death. 95.

II - N.V.N.: Interesting facts of Zhang Jing Yue includes: “Form and structure, blood and energy in individuals of middle and advanced age are of innate nature. Innate is a priori, but great will to improve is a posteriori (acquired). If the innate potential resides in the Blood/Energy of the parents, the acquired potential is found in our heart. In this manner, innate information can be modified by acquired information thanks to the rules of Maintenance-Nutrition.” Those of Yi Shi are added to it:

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“The innate element is the Jing (sexual) of the kidney. After birth, this innate component requires the help of the acquired component (food) to strengthen and consolidate itself. Because, during the penetration of Shui-Gu (Water-Cereals) into the stomach, the 5 flavors/sapors are released and each of them reach the corresponding organ. As for the food liquid, it follows its appropriate paths. The 5 organs receive then the dietary (alimentary) Jing. The kidney is the water-organ; it receives the Jing of the other organs. As a result, in the event of insufficiency of a priori energy, if one obeys the rules of Maintenance-Nutrition, life will be prolonged.”

no 96/97.

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CHAPTER LV Contrary and Favorable (Yi Zuan)

Chapter 55 of the Lingshu speaks: _ on the contrary and favorable of the circulation of the energy _ on the emptiness and fullness of the pulse _ and on the great rules of acupuncture. The application of acupuncture is based on the three following situations: _ the disease cannot be treated by acupuncture _ the disease is not yet at the phase to be treated by acupuncture _ the disease is in the state to be treated by acupuncture. The quality of the knowledge of the mechanism of the evolution of the disease of the good and poor physician is also approached. The essential object of Chapter 55 is to study the opportunity for the application of acupuncture as a function of the determination of the energetic state of the patient, the contrary and favorable circulation of the energy, the emptiness and fullness of the pulse, hence the title: “Contrary and Favorable (Yi Zuan)”. Ma Shi emphasizes: “The contents of Chapter 55 discourses on the contrary and favorable nature of the energy. The acupuncturist-physician must conform to the favorable therapeutic rules and avoid the contrary therapeutic rules. Hence the title of the chapter.” This chapter consists of 2 paragraphs.

PARAGRAPH 1

98.

Huangdi questions Ba Gao: “I have heard: _ that Qi (energy) is endowed with contrary o r favorable n a t u r e _ that Mai (pulse) can be in e x c e s s or i n s u f f i c i e n c y _ and that acupuncture possesses its “ great rules”. Can you explain all this to me?”

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Ba Gao replies: “The energy is endowed with contrary a n d favorable nature in order to respond to Yin and to Yang, to Heaven and to Earth. The pulse is in excess or in insufficiency in order to determine the emptiness or fullness of the blood and energy. Acupuncture possesses its “ great rules” of determination of the indication and contra-indication during treatment of the disease.”

EXPLANATION AND COMMENTARIES I - Zhang Shi explains:

“The energetic diseases follow the movements of the blood and energy to carry out the movements of entering and exiting at the level of the pilocutaneous system and channel system. “The energy is endowed with contrary or favorable natures” wishes to say that the energy located in the interior and at the exterior of the Jingmai circulate according to contrary and favorable movements in order to respond to the movements of ascent/descent of Yin and Yang, Heaven and Earth and the 5 Movements. “The pulse can be in insufficiency or in excess...” indicates that the blood and energy located in the interior and at the exterior of the Jingmai make excessive or insufficient movments of entering or exiting. “The “great rules” of acupuncture” essentially consist of not needling when the disease has already passed.” II - N.V.N.: The contrary and favorable circulations of human energy, the phenomena of the natural world and the rules of modulation of Yin-Yang, of the 4 Seasons and of the 5 Movements are intimately in accord. The resistance and weakness of the pulse can reveal the state of emptiness and fullness of blood and energy, the excessive state of perverse energy and insufficient state of the essential (vital) energy. The “great rules” of needling consist of totally assimilating the pathologic process and comprehending the 3 types of disease for which: _ needling is indicated _ needling is temporarily contra-indicated _ needling is definitely contra-indictated. Zhang Jing Yue clarifies: 99. “1 - Man responds to Heaven and Earth, to the sun and moon and to the movements of ascent/descent of Yin and Yang. When the movements of response are exact and harmonious, they are favorable, and when they are incorrect, they are contrary. 2 - “The pulse can be excessive or insufficient” wishes to say that the pulse appears without force or with force and allows determining the emptiness or fullness of blood and energy.

3 - “The great rules” of needling respect the following 3 principles: _ needling is possible _ needling is not yet possible _ needling is no longer possible. a - “Needling is possible” implies the presence of perverse energy at the level of the channels which one must disperse, as stated in Chapter 17 of this classic (“Measurement of the Vessels”) (1). b - “Needling is not yet possible” means to say that in some circumstances, it must be different, as is recommended in Chapters 9 (“Beginning and Ending”), 26 (“Various Diseases”) and 67 (“Practice of Acupuncture”) of this classic:

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“_ Do not needle individuals after sexual relations _ Do not needle individuals after fatigue _ Do not needle individuals after a meal _ Do not needle individuals when they are hungry _ Do not needle individuals after anger _ Do not needle individuals when they are afraid.” c - “Needling is not possible” indicates that in cases of significant weakness of blood and energy, it is advised against, as is indicated in Chapter 8 of this classic (“Origin of the Mental”) (2).”

PARAGRAPH 2 Huangdi: “How

can

one

determine

the

contra-indications

of

needling?”

Ba Gao: “It is stated in “Military Art”: _ Do not go to meet an army starting to deploy its forces. _ Do not hurry to join a battle judged serious. Similarly, _ Do not _ Do not _ Do not _ Do not discordant.” Huangdi: “And

the

100.

it is stated in “Acupuntural Art”: needle individuals with heat in fullness. needle individuals dripping with sweat. nnedle individuals whose pulse is in upheaval. needle individuals whose pulse and disease are

indications

of

needling?”

Ba Gao: “The superior worker (good physician) needles when the disease is not yet declared; he needles when the clinical signs are not yet in fullness; he needles when the perverse energy is starting to decline. 1. See Volume I of the Lingshu, N.V.N. Edition. 2. Acupuncture is advised against, but moxabustion is absolutely indicated.

The inferior worker (poor physician) needles at the time of attack of perverse energy (disease in phase of state); he needles at the instant when the perverse energy is in fullness at the exterior (of the patient’s body), neglecting the emptiness in the interior; he needles when the signs and pulse are in a discordant state. This is why, it is said: “When the perverse energy is in maximal fullness, we must not disperse it for fear that the essential energy not be injured. We must only needle at the phase of decline of the perverse energy. To practice in this manner is to obtain good results.” It is also said: “The good worker only thinks about detection and treatment. He treats the disease before it declares itself. He does not wait for the disease to carry out

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detection

and

treatment.”

Such is the meaning of the assertion above.” EXPLANATIONS AND COMMENTARIES I - Ma Shi describes:

“1 - This paragraph completes the previous one and speaks about the contra-indications of needling and about the 2 categories of physicians, good and poor, to emphasize the error, despite contra-indications, of continuing to needle. 101. _ “The energy rises up in dense scrolls” implies the fire power of the enemy. _ “The serious battle” means the advantageous situation of the enemy. As a result, one must not go to meet the enemy in full fire power to deliver battle. In other words, it is necessary to wait for the moment of fatigue of the enemy to defeat him. _ “Heat in fullness” implies an intense fever. _ “Dripping sweat” denotes hyperhydrosis. _ “The pulse in upheaval” implies the disordered aspect of the pulse. According to Yang Shang Tian, “In the presence of the disordered pulse, one cannot determine the site of the disease.” All the aforementioned manifestations originate from the peverse energy in a state of fullness and the disease in a state of discordance with the pulse. This is why needling is not indicated. • The superior worker (good physician) treats the disease before it becomes manifest. The inferior worker (poor physician) treats the disease once declared without signs of fullness. The poor worker (bad physician) treats the disease starting to becoming weaker, although it is still in fullness. • Needling is advised against in the following conditions: _ the perverse energy in full rapid expansion _ the disease in full phase of fullness _ the discordance of pulse and signs. In this way, physicians who apply acupuncture despite the contra-indications are very lame physicians. 2 - This Chapter 55 of the Lingshu and Chapter 35 of the Suwen (“Discourse on “Fever-Chills” Disease”) speak on the excessive fullness of the perverse energy, origin of very intense fever. It is advised not to hurry to needle due to the discordance between pulse and signs. It is the same for phytotherapy. Medicines must be prescribed and used before the attack of cold and heat because medicines used at the time of fullness of the perverse energy consolidate the cold if it concerns medicines aimed at refrigerating and consolidate the heat if it concerns medicines aimed at calorificating, hence the worsening of the disease. Clinicians must not ignore these ideas.”

II - N.V.N.:

102.

In relation to “treating before the disease declares itself...”, the conclusion mentioned in Chapter 2 of the Suwen (“Harmonization of the Mental Energy by the Four Seasons”) is as follows: “To conform to the principle of Yin-Yang is life; to break it is death; to follow it is to assure peace; to transgress it is to arouse problems. To not obey it in opposing it is to provoke a separation between the individual and exterior phenomena. For this reason, sages treat before the disease declares itself and assure peace before problems manifest themselves. Therefore, to wait for the disease in order to apply medicines or to wait for problems in order to impose peace is like waiting for thirst in order to dig a well or like waiting for war in order to forge arms. Is it not already too late?”

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One questioned Grand Master Zhang Zhong Jing (150-219 A.D.), author of two famous works, “Shang Han Lun (Evolutive Diseases of Cold)” (3) and “Jin Kui (Box of Gold)”: “What do you mean by “good physicians treat before the disease declares itself?” Here is the reply of the Master: “Take, for example, an ailment of the liver. This illness will spread to the spleen (LiverWood destroys Spleen-Earth). One must immediately tonify the spleen for it has sufficient force to resist destruction due to the liver. As a result, the energy of the liver is required to follow its normal evolution toward the heart (Liver-Wood creates Heart-Fire). To act in this manner is to look to render normal that which is abnormal, is to subdue a rebellion to assure peace. If one waits until the five organs are disturbed, how could one achieve curing them?”

3. Under the title “Evolutive Diseases of the 3 Yin and 3 Yang” (N.V.N. Edition). 103.

CHAPTER LVI The Five Flavors (Wu Wei) 82

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Chapter 56 of the Lingshu speaks on the elective affinities which unite the “Five Flavors (Wu Wei)” with the Five Organs (Wu Zang). In this way, during the metabolism of Shui-Gu (WaterCereals: foods) at the level of the stomach: _ _ _ _ _

the the the the the

sour flavor reaches the liver bitter flavor, the heart sweet flavor, the spleen spicy flavor, the lung salty flavor, the kidney.

This chapter also addresses: _ _ _ _

the 5 types of cereals (grains) the 5 types of vegetables the 5 types of fruits the 5 types of meats... .

Based on the 5 Movements, these food products play a primary pathophysiologic role in the life of the living being. Ma Shi emphasizes: “The key object of Chapter 56 of the Lingshu is to show the correspondances of the “5 Flavors” and “5 Organs”, hence the title, “The 5 Flavors (Wu Wei)”.” This chapter consists of 5 paragraphs.

PARAGRAPH 1

104.

Huangdi questions Ba Gao: “I would like to hear you on the problems of the cereal energies endowed with “5 flavors” saturating the 5 organs. How do you distinguish them?” Ba Gao replies: “The stomach is the “sea” of the 5 organs and 6 bowels, site of reception of Shui Gu (Water-Cereals). the

The 5 organs and 6 bowels receive all cereal energy elaborated at the level of stomach. T h e “ 5 flavors” all flow out _ the s o u r flavor infiltrates _ the biiter flavor, first into _ the s w e e t flavor, first into _ the s p i c y flavor, first into _ the s a l t y flavor, first into

Wei

83

toward their site of distribution. Therefore, first into the liver the heart the spleen the lung the kidney.

The cereal energy and food liquid being formed, Ying (nutritive energy) and (defensive energy) begin to circulate.

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very

After food metabolism, wastes are evacuated toward the bottom following a specific order.”

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains:

“According to Ren Gu Yin, this chapter speaks on the 5 organs/6 bowels, the Xin-Ye (organic liquid), Ying (nutritive energy) and Wei (defensive energy) all originating from the energy of the stomach, that is to say, originating from Shui Gu (Water-Cereals: foods). Once in the stomach, the flavors are divided into 5 types with characteristic affinities with an organ; metabolized liquid becomes distributed according to its appropriate routes, and during the circulation of the cereal energy and food liquid, Ying (nutritive energy) and Wei (defensive energy) communicate. As for the wastes, they are expelled toward the intestines where they undergo a new purification. The liquid thus obtained is brought, under the action of the Xiajiao (Lower Jiao), toward the kidney and bladder... .”

II - N.V.N.: The role of the Sanjiao (SJ) in food metabolism, the formation of blood and energy, the production of organic liquid and the maintenance of mental equilibrium (Shen) has been, many a time, developed in different chapters of the Suwen and Lingshu (1). 1. See N.V.N. Editions.

Recall that: 105.... 1 - The Shangjiao (Upper Jiao-UJ) governs the cardiopulmonary system and controls the diurnal, circadian circulation of Ying energy which, under the action of Tong Qi (a priori energy or ancestral energy) (2), is forced to circulate only within the Jingluo (principal and secondary channels). 2 - The Zhongjiao (Middle Jiao-MJ)) governs the digestive system (Spleen-Stomach) and controls the production of cereal energy which, under the action of the Foot Taiyin (Sp), is brought to the lung (Shu Taiyin) to form the energy called Ying (Rong, nutritive energy). This energy then is composed of: _ terrestrial energy (cereals: diet) _ celestial energy (air: respiration). 106. The Zhongjiao (MJ) emits numerous vessels traveling along the digestive tract. At the level of the intestines, they purify the wastes coming from the stomach before expelling them via the anal route on the one hand, and on the other hand, they decant the food liquid obtained during purification before conducting it to the kidney and liver.

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Figure 1: The 5 flavors and their distribution at the level of the 5 organs. 2. Also called “active” energy or “thoracic” energy. 3 - The Xiajiao (Lower Jiao-LJ) governs the hepato-renal system. It also emits numerous vessels traveling along the “organs-bowels” systems. These vessels follow the routes of the 5 Movements: Kidney--> Liver--> Heart--> Spleen--> Lung--> Kidney

As a result, all activities of the 5 organs and 6 bowels are dependent. The kidney is therefore the “source organ of the organs” (3). At the level of the liver, the Xiajiao (LJ) controls the production of Wei (defensive) energy. It is therefore formed from food liquid which, after numerous phases of decantation, spontaneously passes into the gaseous state equipped with a defensive power against all intrusions. Wei energy also possesses the power to give heat back to the entire organism. It circulates outside the channels following the cycle called “Day/Night”. At the level of the bladder, under the action of the Xiajiao (LJ), the purified water passes to the gallbladder and the impure water is rejected to the exterior via the urethral route in the form of urine. This is why the Suwen states: “The bladder is like a frontier post where food liquid gathers. It is the last relay of energetic transformation.” At the level of the gallbladder, the Xiajiao (LJ) controls the formation of bile, a viscous substance composed of impure liquid of green color coming from the liver (after purification) and pure liquid coming from the bladder. This bile, under the action of the Xiajiao (LJ), pours out into the doudenum by the route of the bile duct to aerate and moisten the intestinal air on the one hand, and on the other hand, to activate the peristaltic movements of the intestines. In conclusion, _ at the exterior, the Sanjiao (SJ) possesses its own channel controlling the external barrier which is the skin, _ and in the interior, it is equipped with numerous vessels controlling not only all organic activities, but also the formation of Qi (energy) (4), Jing (quintessence), Shen (mental), Xue (blood) and Xin-Ye (organic liquid).

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This is why our old masters stated: “Without Sanjiao (SJ), no energetic systems, therefore no life. To delve deeply into the Sanjiao is to be able to treat diseases; if not, the practice of medicine is found at a dead end.” (Figure 2).

3. The kidney does not have a sign of fullness. 4. In medicine, the word Qi designates Ying energy and Wei energy. As a result, the word “breaths” still used by some acupuncturists must be permanently erased from the medical vocabulary of M.T.C. 107.

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Figure 2: Activities of the Sanjiao (SJ).

PARAGRAPH 2 Huangdi: “How do the Ying circulate?”

(nutritive

energy) and Wei

(defensive

energy)

Ba Gao: 108. “Once in the stomach, the cereals release their Jing (quintessence), first at the level of the Zhongjiao (Middle Jiao: MJ), then secondly at the level of the other 2 Jiao: Shangjiao (Upper Jiao: UJ) and Xiajiao (Lower Jiao: LJ) to saturate the 5 organs. This

quintessence

(Jing)

circulates

following

2

paths:

_ t h e Ying path, that is to say, within the channels _ and the W e i path, that is to say, outside the channels. As for Dai Qi (Great Energy: also called Tong Qi = innate or active energy), it accumulates within the thorax without recurring at the place bearing the name Qihai (Sea of Energy) ( 5 ) . This great energy leaves from the lung, runs along the laryngo-pharyngeal system and controls the respiratory movements: _ expiratory movements causing the exit of the energy _ and inspiratory movements causing the entry of the energy.

Jing Qi (pure energy, quintessence) of Heaven and Earth obeying the customary rules (of the natural world), has for exit (at the end of expiration) the number 3 and for entry (at the end of inspiration) the number 1. This is why the absence of entry of cereal energy (into the stomach) in a half day causes weakening of the energy (of the body), and in 1 day, an insufficiency of the energy (of the body).”

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EXPLANATIONS AND COMMENTARIES I - Ma Shi explains: “This paragraph speaks: _ on the transformation of the cereals into Dietary Jing (flavor/sapor) (6), Ying (nutritive energy) and Wei (defensive energy) which maintain the Dai Qi (Great Energy or Tong Qi: a priori energy; active, innate energy), _ and on the amount of energy of exit (cereal energy during expiration) and energy of reentry (“air” energy during inspiration) which the organism needs. This need of cereals is periodic. The stomach receives the Shui Gu (Water-Cereals). Shui Gu is transformed into pure substance (Jing) by the Zhongjiao (Middle Jiao). This pure substance is conducted by the spleen to the lung which transforms it into Ying Qi (nutritive energy) to maintain the 5 organs/6 bowels. • Numerous phases of decantation of dietary liquid take place at the level of the Xiajiao (Lower Jiao: pylorus and duodenum) and intestines. The pure liquid is directed by the Xiajiao (LJ) toward the kidney and liver where it is transformed into into Wei Qi whose main action is to 5. See Chapter 33(“Study of the 4 Seas”) of this classic, Volume II, N.V.N. Edition. Here it concerns Tanzhong (CV 17) bearing the name Shang Qihai (upper Qi Hai). 6. Sapor/Flavor elaborated at the level of the stomach.

defend the organism. As for the Dai Qi (Great Energy: a priori energy), it gathers at the Shangjiao (UJ), at the place called Qihai (“Sea of Energy”), also called Shang Qi Hai (“Upper Sea of Energy”), that is to say, at the point Tanzhong (CV 17). This energy, conducted by the lung toward the laryngo-pharyngeal and olfactory systems, is intended to control the respiratory movments: _ expiration exteriorizes the food/dietary energy (terrestrial) 109. _ inspiration interiorizes the celestial energy (air). • After calculation, at expiration, the cereal energy becomes exteriorized 3 times more than the celestiial energy (air) during inspiration. As a result, in one half day, without absorption of nutrients, the alimentary/dietary Jing grows weak, and in one day without cereals, the alimentary/dietary Jing is found in a state of insufficiency. This is why Zui Tai states: “Without eating 2 times per day, man has hunger”. Such is the meaning of this assertion.”

II - N.V.N.: Anaysis of the number 3 of exit (at the end of expiration) and the number 1 of entry (at the end of inspiration) varies slightly according to the commentators. In this way, after Ma Shi and Zhang Jing Yue: “During expiration, the cereal energy exteriorizes in 3 parts, and during inspiration, the celestial energy (air) interiorizes in 1 part”. And according to Zhang Shi: “Man is maintained by the 5 energies of Heaven and by the 5 Sapors of Earth. Penetration of the 5 Sapors into the stomach is designated by the number 1, number of entry of the cereals. As for the number 3, it designates the 3 phases of digestive transformation: _ into wastes which are expelled to the exterior _ into liquid substance based on the formation of Ying and Wei energies _ into energetic substances which maintain the Tong Qi (a priori energy) which has the ability to control the circulatory movements.” The explantion of Zhang Shi appears to us to be the clearest.

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PARAGRAPH 3 Huangdi: “Would you explain the “5

Flavors” of the cereal to me?”

Ba Gao: “Allow me to explain their details to you: 1. The 5 Grains are: _ ordinary rice, of sweet flavor _ sesame, of sour flavor _ black bean, of salty flavor _ w h e a t , of bitter flavor _ sticky rice, of spicy flavor 2. The 5 Fruits are: _ jujube, of sweet flavor _ p l u m , of sour flavor _ c h e s t n u t , of salty flavor _ apricot, of bitter flavor _ peach, of spicy flavor 3. The 5 Animals a r e : _ beef, of sweet flavor _ dog, of sour flavor _ p i g , of salty flavor _ lamb, of bitter flavor _ chicken, of spicy flavor 4. The 5 Vegetables are _ baselle, ( 7 ) of sweet flavor

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110.

_ chive leaf, of sour flavor _ green bean, of salty flavor _ Chinese chive (shallot), of bitter flavor _ o n i o n , of spicy flavor • _ _ _ _ _

Among the 5 Colors, when the color is y e l l o w , s w e e t flavor is recommended when the color is g r e e n , s o u r flavor is recommended when the color is black, salty flavor is recommended when the color is r e d , b i t t e r flavor is recommended when the color is white, spicy flavor is recommended

7. Climbing plant (“salsolacee” in French) used as a vegetable in tropical regions, particularly in China and Vietnam; Translator’s note: also called “Malabar spinach” whose mucilaginous leaves are very fleshy.

“5

• The association of the 5 Colors and 5 Adaptations”. In this manner,

Flavors/Sapors has the name

1- In the disease of the spleen, it is advised to eat: _ ordinary rice _ beef _ jujube _ baselle which are all of sweet flavor. 2 - In disease of the h e a r t , it is advised to eat: _ wheat _ lamb _ apricot _ Chinese chive (shallot) which are all of bitter flavor. 3 - In disease of the k i d n e y , it is advised to eat: _ soy bean sprouts (soy) _ pork _ chestnut _ bean leaves which are all of salty flavor. 4 - In disease of the l i v e r , it is advised to eat: _ sesame _ dog _ plum _ chive leaf which are all of sour flavor.

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111.

5 - In disease of the lung, it is advised to eat: _ sticky rice _ chicken _ peach _ onion which are all of spicy flavor.”

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains:

“According to Yu Ba Ying: The 5 grains serve to maintain The 5 fruits serve to aid The 5 animals serve to tonify The 5 vegetables serve to consolidate. The energy and sapor therefore are utilized as nutritive substances intended to support and sustain the Jing and conserve Qi. As a result, the 5 flavors/sapors associated with the 5 colors each have their site of appropriate adaptation. In the interior, the 5 organs associate with the 5 Movements, and at the exterior, they respond to the 5 colors. When the 5 sapors/flavors are released at the level of the stomach, each of them direcly reaches its site of affinity, that is to say, the corresponding organ. During this time, the dietary liquid circulates following its own appropriate paths. The 5 sapors/flavors and dietary liquid maintain the 5 organs. This is why, in the event of disturbances of the organs, it is advised to prescribe flavors (foods) which are suitable to them.”

II - N.V.N.: 1 - Previous translations of this paragraph into Western language, particularly about dietary products, are not in agreement with the spirit of the text because, _ Ken Mei deignates ordinary rice _ Huang Shu, sticky rice _ Hua, bean leaves _ Jia, chive leaf. 2 - Zhang Jing Yue furnishes other clarifications: “This paragraph speaks on the adaptations of the 5 Sapors/Flavors to the 5 organs. _ The spleen responds to Earth; the sweet flavor directly reaches the spleen. As a result, in diseases of the spleen, it is advised to use the sweet flavor. _ The heart responds to Fire; the bitter flavor directly reaches the heart. As a result, in diseases of the heart, it is advised to use the bitter flavor. _ The kidney responds to Water; the salty flavor directly reaches the kidney. As a result, in diseases of the kidney, it is advise to use the salty flavor. _ The liver responds to Wood; the sour flavor directly reaches the liver. As a result, in diseases of the liver, it is advised to use the sour flavor. _ The lung responds to Metal; the spicy flavor directly reaches the lung. As a result, in diseases of the lung, it is advised to use the spicy flavor.

This paragraph has the same meaning as that of the “5 Renions” cited in Chapter 10 (“Production and

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Transformation of the 5 Organs”) and the “5 Penetrations” cited in Chapter 23 (“Discourse on the Five Energies”) of the Suwen (8) because the 5 flavors/sapors are used to treat diseases of the corresponding organs.

PARAGRAPH 4 “The “5 _ _ _ _ _

113.

prohibitions” are:

spicy flavor is prohibited in diseases of the liver s a l t y flavor is prohibited in diseases of the heart s o u r flavor is prohibited in diseases of the spleen sweet flavor is prohibited in diseases of the kidney bitter flavor is prohibited in diseases of the lung.”

8. See Suwen, Volume II, N.V.N. Edition.

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains:

“According to Yu Shi, the 5 Energies (9) and 5 Flavors each have an appropriate action of stimulation and inhibition, of tonification and dispersion. This is why, in diseases of the 5 organs, it is expressly prohibited to use flavors of inhibitory or dispersing action.” II - N.V.N.: We present below a diagram of the flavors/sapors of inhibitory and stimulating action.

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Figure 3: Inhibitory and stimulating action of the 5 flavors/sapors.

9. Here, the “5 Energies” designate: _ energy of the heart _ energy of the lung _ energy of the liver

_ energy of the spleen _ energy of the kidney

The notion of the “5 Prohibitions” is also found in Chapter 23 of the Suwen (“Discourse on the Five

Energies”).

114.

Therefore,

following the laws of the 5 Movements: _ spicy belonging to Metal can inhibit Liver-Wood. In diseases of the liver, spicy foods are therefore prohibited. _ salty responding to Water can inhibit Heart-Fire. In diseases of the heart, salty foods are therefore prohibited. _ sour corresponding to Wood can inhibit Spleen-Earth. In diseases of the spleen, sour foods are therefore prohibited. _ sweet responding to Earth can inhibit Kidney-Water. In diseases of the kidney, sweet foods are therefore prohibited. _ bitter corresponding to Fire can inhibit Lung-Metal. In diseases of the lung, bitter foods are therefore prohibited.

PARAGRAPH 5 “_ The liver responds to the color green. It is advised to eat: • ordinary rice • beef • jujube • baselle which are all of s w e e t flavor. _ The heart responds to the color red. It is advised to eat: • sesame • dog • plum • chive leaf which are all of sour f l a v o r .

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_ The spleen responds to the color yellow. It is advised to eat: • soy • pork • chestnut • bean leaves which are all of s a l t y flavor. _ The lung responds to the color white. It is advised to eat: • wheat • lamb • apricot • Chinese chive (shallot) which are all of b i t t e r flavor.

115.

_ The kidney responds to the color black. It is advised to eat: • sticky rice • chicken • peach • onion which are all of spicy f l a v o r . ” EXPLANATION AND COMMENTARIES I - Ma Shi explains:

“This paragraph speaks on the flavors indicated in the case of “suffering” of the 5 organs. 1 - In Chapter 22 of the Suwen (“Energy of the Organs and the Laws of the 4 Seasons”) we read: _ The liver suffers from excess (too tense, contracted). One must hasten to relax it by a diet of sweet flavor. _ The heart suffers from a slowing down. It is relaxed. One must hasten to tighten it by a diet of sour flavor. _ The spleen suffers from humidity. One must hasten to dry it by a diet of salty flavor. _ The lung suffers from the ascent of the energy (--> blockage). One must hasten to release it and rebalance it by a diet of bitter flavor. _ The kidney suffers from dryness. One must hasten to moisten it by a diet of spicy flavor. • In the end, it is said: “The liver responds to the color green. It is advised to eat foods of sweet flavor: ordinary rice, beef, jujube, baselle...”. It is also said: “The spleen detests humidity. One must hasten to eat foods of bitter flavor, in order to dry it...”. Then it is also said: “The spleen responds to the color yellow. One must eat foods of salty flavor...”. What does that mean? 2 - Qie Xuan Shi clarifies: In analyzing the recommended foods, one notices that they serve to aerate the system of the 5 organs. The kidney is the “door” of the stomach and the stomach is connected to the spleen. This is why one serves the salty flavor of supple and fine nature in order to “open the door”. Once the door opens, the energy of the stomach frees itself which permits activation of food metabolism. This is why, in relation to the spleen, the indicated foods differ in relation to those of the other organs.” 116.

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II - N.V.N.: In conclusion, Chinese dietetics, simple and clear, is based on the formation of Dietary Jing (cereal quintessence) bearing the name “flavor/sapor”, and this Dietary Jing is under the action of the Sanjiao (SJ) and the 5 Movements. We present below a table of penetration of the 5 Flavors/Sapors.

5 Grains

5 Fruits

sesame

plum

Bitter

wheat

apricot

Sweet

common rice

jujube

Spicy

sticky rice

peach

Salty

black bean

chestnut

5 Sapors

Sour

95

5 Animals

5 Vegetables

Site of Penetration

Indications

ContraIndications

shallot

liver

green color, diseases of diseases of the liver and the spleen heart

lamb

Chinese chive

heart

red color, diseases of and heart and lung

diseases of the lung

beef

baselle

spleen

yellow color, diseases of the spleen and liver

diseases of the kidney

chicken

onion

lung

white color, diseases of the lung and kidney

diseases of the liver

pork

soy

kidney

black color, diseases of the kidney and spleen

diseases of the heart

dog

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117.

CHAPTER LVII Hydropsy (Shui Zhang)

Chapter 57 of the Lingshu speaks on the etiology, symptomatology and different methods of diagnosing such illnesses as: _ _ _ _ _

Shui Zhang (hydropsy) Fu Zhang (anasarca) Gu Zhang (tympanism) Zhang Tan (polyps) Shu Jia (fibroma)...

among which Shui Zhang (hydropsy) is taken as the title of this chapter.

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This chapter consists of 6 paragraphs.

PARAGRAPH 1 Huangdi questions Qi Bo: “How can one differentiate _ Shui Zhang ( h y d r o p s y ) _ Fu Zhang ( a n a s a r c a ) _ Gu Zhang ( t y m p a n i s m ) _ Zhang Tan ( p o l y p s ) _ Shi Jia ( f i b r o m a ) _ and Shi Shui ( h y d r o n e p h r o s i s ) ? ”

118.

Qi Bo replies: “At the starting phase of the disease of Shui Zhang (hydropsy) the clinical signs are: _ slightly swollen lower eyelid as when waking up _ pulse of the neck (carotid) agitated _ sometimes, cough _ cold at the inner thigh _ edematous feet and legs. Progressive swelling of the abdomen indicates the formation of Shui Zhang (hydropsy). This is why the stomach molds the upthrusting movement of the hand, without retaining the impression of the pressure as if it contained a water pocket. Such are the signs of manifestation of Shui Zhang (hydropsy). ”

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains: “This paragraph speaks on the liquid overflowing of the Foot Taiyang (Bl) toward the skin to trigger the syndrome Shui Zhang. In other words, this overflowing of water is due to the insufficiency of the energy of the Taiyang (Bl) not being able to retain the liquid component. The Foot Taiyang (Bl) starts at the internal canthus of the eye, reaches the forehead, arrives at the cranial vault and passes to the nucha where it carries out movements of descent... . “Lower eyelids slightly swollen” denotes that the liquid substance follows the route of the channels

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overflowing the upper part. “Agitated pulse of the neck (carotid pulse)” results in a perturbation due to the reascent of water at the level of the vessel (artery). “Cough” is due to an attack of the lung by the “water” energy. “Cold at the inner thigh and legs” is the consequence of an insufficiency of the energy of the Taiyang (Bl) which provokes an accumulation of Water-Cold toward the bottom. “Abdominal swelling” indicates the overflowing of water toward the top provoking respiratory problems. “The skin does not retain the impression of the fingers” because the water rises up and follows the movement of the fingers. Such are the manifestations of the syndrome Shui Zhang (hydropsy).” 119.

II - Ma Shi states: “Shui Zhang originates from the insufficiency of the “Humidity” energy of Spleen-Earth not being able to inhibit water. Cold-Water accumulates within the stomach and intestines. This is why the Renying (carotid) pulse is agitated, and during cough the agitation is in the interior (abdomen) which causes Cold-Water toward the bottom, hence sensation of cold at the inner thigh and edema of the legs and feet. The absence of the impression of the hand after pressing is the sign revealing the presence of water within the belly (ascites).”

III - N.V.N.: According to Chapter 7 of the Suwen (“Special Study on Yin and Yang”): “The union of the 3 Yin is called Water”. Wang Bing (762 A.D.) furnishes the following clarifications: “Here, 3 Yin designates 2 channels, Yin of the spleen and lung which are attacked by Cold. When Cold accumulates within these channels, it transforms into Water.” In Chapter 36 of the Lingshu (“Distinction of the 5 Types of Liquid Retention”), we read, recalling the subject of the metabolism of organic liquid and hydropsy: “... Xin Ye (organic liquid) coming from the Wu Gu (5 cereals) can be transformed into fatty substance (Gao) which, from the exterior, permeates the bony cavitites and maintains the marrow and brain, then it flows out toward the bottom into the internal part of the thigh. The disequilibrium of Yin and Yang provokes the overflowing of Ye (viscous liquid) which flows out toward the Yin orifices; Ye and marrow becomes reduced and accumulate at the bottom. If the accumulation (at the bottom) is too abundant, it produces phenomena of emptiness (at the level of the marrow) indicated by lumbo-dorsalgia and ostealgia of the lower limbs. During this time, _ the energetic routes of Yin and Yang are obstructed and the 4 “Seas” are blocked _ the Sanjiao (SJ) no longer insures the function of “release” (deobstruction) _ the Xin-Ye are no longer metabolised _ the cereal liquid accumulates within the stomach and intestines and food wastes do not arrive at the large intestine _ the liquid retained within the Xiajiao (LJ) no longer saturates the bladder and provokes a syndrome known as “Retention of Xiajiao (LJ)” and its overflowing causes the syndrome of retention of water (hydropsy)...”.

PARAGRAPH 2 98

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Huangdi: “How does Fu Zhang (anasarca) m a n i f e s t ? ”

120.

Qi Bo:

“ Fu Zhang (anasarca) is due to the fixation of “Cold” energy within the subcutaneous spaces. To the touch, _ it is soft and emits a buzzing sound in the interior _ the belly is bloated _ the entire body is swollen _ the thickened skin retains the impression of the fingers _ the color of the skin is not changed. Such are the manifestations of Fu Zhang (anasarca). ”

EXPLANATIONS AND COMMENTARIES I - Ma Shi explains:

“Cold is the energy of water. It is an energy (immaterial substance) remaining within the cutaneous spaces causing the syndrome of swelling-emptiness. As a result of the immaterial nature of the energy, one perceives, during percussion, a buzzing sound without the quality of hardness. It is a matter of an energetic retention. This is why the belly is swollen and the entire body is edematous (anasarca). “The skin is thickened” because the perverse energy is found restrained there. In the previous paragraph, water (material substance) infiltrated into the skin which does not retain the impression of the fingers, while in this paragraph it concerns an energetic retention, the impresion of the fingers is retained and the color of the skin of the abdomen is not changed. Here the “cold” energy is fixed within the skin and Spleen-Earth is not damaged.”

II - N.V.N.: This paragraph explains the presence of the sign of “pitting” in anasarca (of energetic origin); the previous one spoke on the absence of pitting in hydropsy (of liquid origin). The differential diagnosis of anasarca and hydropsy established by Zhang Jing Yue is the following: “a - The “cold” energy lodged in the skin prevents the Yang energy from circulating. The disease is located within the energetic part, hence production of a “buzzing sound” evoking the image of a drum roll. By its nature, energy is immaterial. Therefore, “it does not linger to the touch”. The energy travels up and down the entire body, hence “abdominal swelling and anasarca with thickened skin”. With pressure of the fingers, the energy spreads out toward the sides, hence “the impression of the fingers” (sign of pitting).

b - Anasarca and hydropsy are not diagnosed in the same way. One must look for their origin (energetic or liquid) in order to study: _ the thickness of the skin 121. _ the presence or absence of the impression of the fingers _ the change or not of abdominal color. The detailed study of these illnesses is clarified in the Jin Qiu (Box of Gold) of Zhang Zhong Jing of the Han Dynasty of the East (150-219 A.D.)“. The explanation of Zhang Jing Yue (1563-1640 A.D.) confirms the importance of Chinese energetic medicine.

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Chinese medicine must be considered not as an “alternative medicine” or a parallel medicine in reference to medicine called scientific, but as a medicine based totally on the ultramodern notion: “matter and energy” (two inseparable notions).

PARAGRAPH 3 Huangdi: “How does Gu

Zhang

(tympanism)

manifest?”

Qi Bo:

“The body and belly are swollen as in Fu Zhang (anasarca). But the skin of the abdomen is greyish-yellow with the appearance of collateral circulation around the umbilicus. Such is the manifestation of Gu Zhang (tympanism) . ” EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains: “Gu Zhang is due to a massive infiltration of “cold” energy within the empty spaces of the organism. This means to say that it is due to a retention/accumulation of cold. The abundance of retention/accumulation of “cold” energy in the “Water” organ (Kidney) causes a pronounced dimunition of the potential of “Fire” (Heart) and “Earth” (Spleen) energy. “The entire body is swollen” because the spleen governs the “flesh” (dermis) system. “Grayish yellow color with collateral circulation at the level of the abdomen” denotes the defeat of Spleen (Earth) with invasion of “Wood” (Liver) energy.”

II - N.V.N.: 1 - In the Dictionary of Oriental Medicine we read: “In the presence of Gu Zhang (tympanism), the skin of the abdomen is tense like that of the drum; the interior is empty and the impression of the fingers is absent to pressure.” 122.

2 - In Chapter 74 of the Suwen (“Great Study on the True Basic Notions”), Qi Bo states: “Boborygmi and tympanism belongs to the heat whose potential is in a state of pronounced dimunition.” 3 - In Chapter 40 of the same classic (“Study on Abdomen-Center”), Huangdi questions Qi Bo:

“There exists a type of abdominal swelling which permits the individual to have lunch but not dinner. Which is this disease? Qi Bo replies: This disease is called Gu Zhang (tympanism).”

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PARAGRAPH 4 Huangdi: “How does Zhang

Tan

(polyp)

manifest?”

Qi Bo:

“The “Cold” energy retained at the exterior of the intestines goes into battle against the Wei (defensive) energy. Following this confrontation, the Wei gathers and stagnates, hence the production of toxic energy and formation of Xi Rou (intestinal or mucous or fibrous uterine excresences or outgrowths, implanted by a pedicle: “polyp”) ( 1 ) . At the start, Xi Rou is the size of an egg, then it progressively develops as if the woman was pregnant. In the long run, it is hard to palpation and displaces with pressure...; the rules are consistent. Such are the symptoms of Zhang

Tan

(polyps). ”

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains:

“This paragraph speaks on the formation of Zhang Tan (polyp) due to the presence of “cold” energy localizing at the exterior of the intestines, at the level of the serous membranes/ serosa (intestinal). Because, during the night, the Wei (defensive) energy passes to the serous membranes of the organs and bowels and accomplishes 25 turns in the areas of the Yin channels. When the perverse cold remains within the abdominal cavity, at the level of the serous membranes, it clashes with the Wei energy. Wei stops circulating and brings with it blood stasis. This accidental union causes the production of toxic energy which adheres to the intestinal serosa creating Xi Rou (excresence/outgrowth of flesh). In the chronic state, Zhang Tan detaches from the serosa of the bowel like a suspended fetus. Because it does have any relationship with the organs or bowels, it does not affect menstruation.” II - N.V.N.:

123.

Zhang Jing Yue gives us the definition of Zhang Tan and Xi Rou: “The word Tan implies the sense of opening widely and deeply. The confrontation of perverse cold and Wei (defensive) energy within the abdominal cavity at the exterior of the intestinal serosa is indicated by an energetic mass which transforms rapidly into Xi Rou (fibrous or

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mucous excresence: polyp) which develops progressively to the chronic state. The term Xi Rou also indicates a mass of flesh permeated by thick and stagnant blood. Here, the cold perverse is located at the exterior of the stomach and intestines and does not infiltrate into the uterus. As a result, it does not affect menstruation. It is not then a matter a blood disease. Zhang Tan simply originates from a fusion of toxic energy released during the confrontation of Wei (defensive) and cold perverse energies.”

1. Fibrous or mucous polyp without disturbance of the cycle.

PARAGRAPH 5 Huangdi: “How does Shi Jia (fibrous mass, hard as stone: “ fibroma”)

manifest?”

Qi Bo:

“ Shi Jia manifests within the uterus. “Cold” perverse energy remains at “the door” of the uterus (uterine neck), hence obstruction of the uterus preventing its energy from communicating with the exterior. Thick blood cannot be evacuated. The blood mass retained within the uterus progressively increases in volume like a pregnant woman, with disturbance of menstruation. This illness only takes place in women. One can use the method expulsion of blood to evacuate it.”

EXPLANATIONS AND COMMENTARIES I - Ma Shi describes: “Shi Jia (fibrous mass, hard like stone: fibroma) forms in the interior of the uterus because of the fixation of “cold” energy at the door of the uterus (uterine neck), preventing the energy from communicating with the exterior. The viscous blood and uterine energy retained within the uterus transforms into a blood-energy mass which progressively develops like a fetus in a pregnant woman... . Because the formation of Shi Jia is intra-uterine, the rules are inconsistent.” 124.

II - N.V.N.: Zhang Jing Yue emphasizes: “When the “fetal door” (uterine neck) is obstructed by perverse cold, thick blood cannot be evacuated and becomes a stone-hard mass, hence the name Shi Jia. The rules then are variable. We can use medicines called “Conduction of Blood” to evacuate it toward the bottom.”

PARAGRAPH 6 Huangdi: “Can one needle in the event of Fu (tympanism)? ”

102

Zhang

(anasarca) and Gu

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Zhang

Qi Bo:

“Utilize needles first to disperse the places where the Xuo Luo (blood c a p i l l a r i e s ) appear, then balance the Jingmai (principal channels). The key point is to evacuate the thick blood at the level of the Xue Luo. ” EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains: “Fu Zhang (anasarca) is caused by the presence of perverse cold at the external part of the body, while Gu Zhang (tympanism) is caused by perverse cold within the internal psrt of the body. This is why: _ first, disperse the Xuo Luo _ second, balance the Jingmai _ and last, make the Xue Luo bleed to evacuate the viscous blood.”

II - N.V.N.: Blood stasis at the level of the Sun Luo (secondary vessels) are also studied in Chapter 39 of this classic (“Study on Stasis at the Level of the Blood Luo”) (2): “In fullness, the Xue Luo are hard, red in color and arranged by length and width, at the top or at the bottom, without fixed localization; sometimes they are as fine as needles, sometimes they are as large as chopsticks. It is necessary to disperse according to the rules and not make a mistake of “number” of the needling of the Luo. To do the opposite is to provoke the above-noted signs.” Blood stases at the level of the Jingluo (principal and secondary channels), in particular at the level of the Sun Luo (energetic capillaries), very common in clinic, are the precursor signs of numerous illnesses. Ma Shi emphasizes the method of dispersion of the Luo, according to the technique known as “in opposition”: 125.

“This paragraph explains the method of examination of blood stases at the level of the Jingluo (principal and secondary channels) whose ideal therapeutic technique is dispersion which consists of inclining the needle to perform movements called “in opposition”. This technique is in agreement with the “numbered” technique cited in the text. In contrast, the opposite technique can cause unfavorable signs like fainting, spurting out of the blood, swelling...“. • We present below a summary table of etiology, symptomatology and diagnosis of the 5 diseases (hydropsy, anasarca, tympanism, polyp and fibroma) cited in the text of this chapter. Note, however, that in this Chapter 57 of the Lingshu, Huangdi also questioned Qi Bo about the formation of Shi Shui (hydronephrosis) (3). His reply is found in Chapter 7 of the Suwen (“Special Study on Yin and Yang”) and in Chapter 4 of the Lingshu (“Pathologic Forms of Attack of the Organs and Bowels by Perverse Energy”). a - In Chapter 7 of the Suwen, we read: “The concentration of perverse energy simultaneously in Yin and in Yang provokes Shi Shui (Stone-Water: hydronephrosis).” The explanation of Zhang Shi is the following:

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“In relation to the human body, exterior is Yang, interior is Yin, stomach is Yang, kidneys are Yin. We read in the Neijing that the kidneys are the “doors” of the stomach because the stomach 2. Cf. Lingshu, Volume II, p. 257, N.V.N. Edition, English translation by ESG. 3. Literally, “Shi” = stone; “Shui” = water. It encompasses the group of diseases of renal origin such as: hydronephrosis, ascites, nephrolithiasis... .

communicates with the kidneys via the intermediary of the Lower Jiao (Xiajiao). The Lower Jiao leads the dietary liquid toward the intestines, then from the intestines toward the kidneys via its “internal duct” (internal trajectory). (Figure 1) When the doors (kidneys) are “closed”, water accumulates within the peritoneal space located between the kidneys and stomach, hence ascites with hard belly; or else it accumulates within the kidneys, hence hydronephrosis. These illnesses have the tendency to lean even more to the Yin side than to the Yang side; this is because they present more Yin signs than Yang signs.” b - Chapter 4 of the Lingshu (4) also describes the pulse concerning Shi Shui: “...The very changing (Da) pulse of the kidney is the signs of Yin Wei (sexual impotence). Barely changing, it is the sign of Shi Shui (hydronephrosis). This disease starts at the sub-umbilical region and reaches the lower abdomen. When it ascends to the stomach, it is death”. Here is the explanation of Zhang Shi: “Yin Wei (sexual impotence) is an ailment characterized by a deadening of Yin, hence inability to have erection. As for Shi Shui (hydronephrosis), it is of “Kidney-Water” origin. When is reaches the top, that is to say, the stomach, it constitutes what one calls “phenomenon of overflowing of Water (Kidney) with defeat of Earth (Spleen).” 126.

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Figure 1: Energy of the Lower Jiao (Xiajiao) and the kidneys. Ma Shi adds: “The changing (Da) pulse is a pathologic pulse of the heart. If the pulse of the kidney is very changing, it is the sign revealing the excess of Fire and shortage of Water, responsible for Yin Wei (sexual impotence). Barely changing, it is the sign of the presence of Shi Shui (hydronephrosis). Below, this affliction reaches the hypogastrium giving it a ptotic appearance, and above, it affects the epigastrium. This disease is fatal. Also Chapter 7 of the Suwen states: “Yin and Yang become concentrated because there is a plethora of Yin and deficiency of Yang. This state is the origin of Shi Shui (hydronephrosis).” 127.

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Diseases

Etiology

Symptomatology

Shui Zhang (Hydropsy)

According to Ma and Zhang: _ overflowing or water due to insufficiency of energy “cold” of Taiyang (Bl) “humidity” of Taiyin (Sp)

Fu Zhang (Anasarca)

_ Fixation of perverse “cold” energy within the cutaneous spaces

Starting phase: _ palpebral edema _ agitated carotid pulse _ cold at the inner thigh _ swollen legs and feet

Diagnosis _ Absence of pitting (Water follows the movement of the fingers during pressure)

then abdomnal swelling

_ generalized edema _ big abdomen _ thickened skin _ absence of change of the color of the skin

_ Presnce of pitting (The energy does not follow the movements of the fingers)

• to the touch: _ soft _ buzzing sound

Gu Zhang (Tympanism)

Zhang Tan (Polyp)

Shi Jia (Fibroma)

Acording to Zhang Shi: _ massive infiltration of “cold” perverse within the empty spaces of the organism (abdomen) “Cold” perverse energy retained within the abdominal cavity, at the exterior of the intestines:

_ Swollen body as in anasarca

_ Greyish yellow abdominal skin _ collateral circulation

_ the size of an egg then develops as in a pregnant woman

_ Extra-uterine formation without effect on menstruation (normal rules)

_ progressive increase of fibromatous mass as in a pregnant woman

Intra-uterine formation, influencing menstruation (absence of rules)

_ Energetic and blood stasis (thick energy and blood)

Perverse “cold” energy retained within the uterine neck: _ obstruction of the uterus _ thick energy and blood unable to be evacuated.

no 128/129.

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CHAPTER LVIII Pirate Wind (Zie Feng) (1)

Chapter 58 of the Lingshu gives dissertation on Zie Feng Xie Qi (Pirate Wind, perverse energy), erratic and disorderd energy of the 4 Seasons, very harmful, able to cause numerous diseases. But, clinically, diseases can be triggered in individuals carrying “latent perverse energy”, _ during a new infiltration of “recent perverse energy”, _ during a digestive disorder _ or during a psycho-afffective disturbance (causal factors of circulatory disturbances of blood and energy). The causes of the disease are therefore numerous. But the essential object of this chapter is centered on diseases caused by Zie Feng, hence the title of this chapter: “Pirate Wind (Zie Feng)”. This chapter consists of 3 paragraphs.

1. Regarding “Zie Feng”, consult Chapter 79 (“Years and Dew”) of this classic.

PARAGRAPH 1 Huangdi: “You have often affirmed that Zie Feng (Pirate Wind, Bandit Wind, Rascal Wind = disordered energy of the 4 Seasons) is a harmful energy able to cause numerous diseases. Yet, clearly, people, sheltered behind partitions or not leaving their room, abruptly become ill... . This is not because they do not know how to defend against the wind; what are then the causes?” 130.

Qi Bo:

“These individuals are certainly carriers of the energy “Latent Perverse Humidity” concealed within the Xue Mai (blood capillaries) and within Fen Rou

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(demarcation of the flesh: dermo-dermal system). Also, they are ill: _ because they are keepers of thick blood after a fall, _ because they are in the grip of a joy or sudden sorrow, _ because their diet is poorly regulated _ because they are neither adapted to cold nor heat, _ and, finally, because they are subjected to an attack of Wind-Cold during opening of the pores causing a stagnation of blood and energy with fusion of recent perverse energy and latent perverse energy, responsible for the syndrome Han Bi (algoparesthesia caused by cold). Sweating caused by heat also favors the penetration of wind to cause disease. Therefore, aside from Zie Feng (Pirate Wind), the disease is surely due to other causes.”

EXPLANATIONS AND COMMENTARIES I - Ma Shi explains:

“This paragraph speaks about individuals carrying “latent perverse energy” subjected to a new attack of “recent perverse energy” which triggers disease. In other words, the disease is not only caused by Zie Feng (Pirate Wind or disordered seasonal energy), but also by other factors. The penetration of Zie Feng into the organism, responsible for the disease, is a common and natural phenomenon. Yet, there are individuals who, locked up in their room without contact with Zie Feng, suddenly fall ill. Huangdi expresses doubt about this phenomenon, hence Qi Bo’s reply.”

II - N.V.N.: Wind, cold, heat, humidity, dryness and fire form the group of normal and variable energies of the 4 seasons. During their abnormal appearance, they carry the name “disordered energies” or Zie Feng (Pirate Wind) and constitute etiologic factors of diseases.

Therefore, for example: _ in spring, the majority of diseases are caused by wind _ in summer, the majority of diseases are caused by heat _ at end of summer, the majority of diseases are caused by humidity _ in autumn, the majority of diseases are caused by dryness _ in winter, the majority of diseases are caused by cold.

131.

This is the general rule of the diseases known as “offensive” (Wai Gan) diseases of the 4 seasons. But during one season, the offensive disease can present with a wide diversity of clinical forms due to the complexity of the human terrain. Moreover, any perverse energy can combine one to the other and trigger a more complex disease. Therefore, wind can be associated with cold or other perverse energies, hence the numerous clinical forms because of the combination of different causes. Example: in articular Bi, the association of 3 perverse energies (wind, cold, humidity) is always permanent feature. Yang Si Fang states: “• If Wind injures the Qi (energy) _ if Cold injures the Shen (mental)

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_ and if Humidity injures the Jing (quntessence) it is because: _ Wind injures the Wei (defensive energy) _ Cold injures the Ying (nutritive energy) _ Cold-Water injures Heart-Fire. • Humidity is the perverse energy of Earth. It injures the Jing Qi (energetic quintessence) of the kidney; this is why, during attack of humidity, the four limbs are cold (Ni Jue).”

PARAGRAPH 2 Huangdi: “What you have come to inform me is that the patients had experienced it themselves. But some individuals not exposed to perverse energy and not having any reason to be frightened are suddenly taken ill... Why? Is it due to a demon or spirit (Gui Shen)?” Qi Bo:

“This also originates from “latent manifested.

perverse

energy” which has not yet

On the occaision of an annoyance or compassion, blood and energy, being disturbed within the interior, clash with one another. The cause is found then within the interior and the depth; it is neither visible, nor audible. This is why one attributes it to Gui (demon) and Shen (mental). ”

EXPLANATIONS AND COMMENTARIES

132.

I - Zhang Shi explains:

“This paragraph explains disorders of the Jing (quintessence), Qi (energy) and Shen (mental) due to the presence of “latent perverse energy” localizing within the epidermo-dermal spaces and at the level of Yuan Ma (fibrous, serous and mucous membranes) (2). Jing of Water is Chi (will). Jing of Fire is Shen (mental). When Chi (will) is thwarted, it injures the Jing of the kidney organ, and when the heart is taken by emotion, it injures the Shen (mental). As a result, _ blood and energy are disturbed in the interior, _ the source energy and perverse energy confront one another. Causal seeds are then formed before the disease declares itself. Here, it is a matter of an illness of Qi (energy) and not an illness of Xing (form). This is why it is neither visible nor audible as if were provoked by Gui Shen (demon-spirit). In reality, these do not exist.”

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II - Ma Shi states:

“Generally, “latent perverse energy” (like humidity) is concealed in place within the organism and waits for the favorable moment of a new attack of “recent perverse energy” to deploy or spread. The battle between these two perverse energies (latent and recent) causes disorders of the blood and energy, hence illness. All these manifestations take place in invisible and silent fashion. Failing to appreciate these facts, one attributes them to demons and spirits.”

III - N.V.N.: 1 - In practice, it is necessary to base one’s judgment on the duration of the seriousness of the symptoms to distinguish latent perverse energy and recent perverse energy. If the symptomatology of latent perverse energy is followed by signs of chronic disease, the recent perverse energy activates the latent perverse energy. In contrast, if, at the starting phase, in the absence of symptomatology of latent perverse energy, the disease manifests by serious signs of marked fever, evolving toward the syndrome of Dryness “burning the Yin root”, it si the sign of auto-manifestation of latent perverse energy. 133.

2 - The explanation of Zhang Shi is crucial to the comprehension of the fixation of latent perverse energy within the epidermo-dermal spaces and at the level of Yuan Ma. This fact is due to the insufficiency of Wei (defensive) energy. Knowledge of the formation of Wei (defensive energy), Ying (nutritive energy), Jing (quintessence) and Shen (mental) therefore permit resolution of all pathologic problems.

2. Designates a thin layer of tissue that envelops an organ (i.e. pleura), cavity (peritoneum) or natural conduit (aponeurosis, choroid, endocardium, ependyma, meninges, etc.).

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Figure 1:

Defensive functions of Wei energy.

PARAGRAPH 3 Huangdi: “Some illnesses are cured by Zhu Wu (invocation). How is that?” Qi Bo:

“In the knowledge of departure of “invocation”

past, Tian Wu (cult masters) treated illnesses as a function of the the phenomena of “victory” of the disease and the points of its manifestations... from which they applied the method of (Zhu Wu). ” 134.

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains: “To know the phenomena of “victory” of the disease” is to know how to identify the triumphant action of Jing (quintessence), Qi (Ying and Wei energy) and Shen (mental) over diseases. The “method of invocation” is an everyday therapy practiced long ago, before and during the time of Huangdi, based on the perfect knowledge of the phenomena of “repression” of the law of the 5 Movements”. Yang Shi Feng has stated: “In antiquity, Zhu Wu (invocation) was a medical speciality classed among the “13 Other Arts” of the era. The Tian Wu (Masters of Worship) practiced this science. This is why the ideogram “Yi” (ancient character designating “physician”) contained within its lower part the ideogram “Wu” (cult). Thus, one must not confuse Wu Yi (Masters of Worship/physician) (3) with the Tong Gu (sourcerers). This is like the “Southerners” (designating Chinese of the South and Vietnamese) still using the old adage: “Without imprinting on humanism, one can never become Wu Yi.”

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Figure 2: Movements of repression of the law of the 5 Movements.

135.

II - N.V.N.: 1 - Chapter 13 of the Suwen (“Mobilization of Jing and the Transformation of the Energy”) is devoted to the method of Zhu Wu (invocation or ancient psychotherapy): “Huangdi: I have heard it said that in ancient times, it was sufficient, to cure diseases, to employ the method of “Zhu Wu” (invocations) which permitted realizing the beneficial transformations of the mental energy (Jing) and biologic energy (Qi). Today, how does it come to be that, with medications against internal diseases and needles of stone (lithopuncture) against external diseases, treatment proves to be ineffective?” 3. In this regard, in French and German language, one translates it “sorcerer”, which makes M.T.C. lose its historic and medical value.

Qi Bo: In the past, man lived among the birds and quadripeds. He engaged in exercise to struggle against the cold and went into the shade and coolness to avoid the heat (of the sun). In the interior, no passion could disturb his mind; at the exterior, no public function could hinder his freedom of action. In this way, in this time of calm amd sobriety, the mental state of man was solid in the interior; the perverse energy from the exterior could not penetrate deeply into the body. This is the reason why medications were not necessary to treat internal diseases, and needles of stone were not necessary to look after external diseases. Mental changes brought about by “invocations” were sufficient. Man today is no longer the same. He is overwhelmed by worry in the interior and overwork at the exterior. Moreover, he does not follow the evolution of the energy of the four seasons and falls victim to attack by perverse wind. Therefore, the energy of the body is in insufficiency (emptiness); perverse energy profits from this emptiness, insulting it day and night. In the interior, it penetrates deeply to the organs and bowels, bones and marrows; at the exterior, it causes damage to the orifices (nose, mouth,...), flesh and skin. Slight illnesses become serious, the most serious becoming fatal. In this case, the Zhu Wu method is ineffective.” 2 - According to Wang Bing (physician of the Tang Dynasty, 762 A.D.): “Zhu Wu is a ancient method of treatment which consisted of meditating to look for the causes of the disease without the aid of medicines or needles.”

Zhu Wu can be considered an original form of psychotherapy. It was an everyday practice in antiquity when one acknowledged a deep interdependence between psychologic phenomena. This interdepenednce justified

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the application of this method, not only in psychologic illnesses, but also in organic illnesses whose genesis was always favored, according to this conception, by the intervention of psychologic factors (worries of all orders, emotional shock, various conflicts, the struggle for existence...). 136.

This non-systematized psychotherapy presents several important characteristics which merit being emphasized:

a - Use of sacred rites: They take place in an atmosphere marked with piety and devotion, often before an altar intended for the worship of ancestors. They consist of inviting the patient to “pray”, “meditate” on his illness and ingest a little glass of water (containing some ashes of sticks of incense). b - Prayers: They are directed at acquiring the beneficial influence of the Supreme Being on the illness. This spiritual faith, which added to the physiologic action of the therapy itself, permitted a tenfold increase in the chances for cure. c - Evocation of all causes of the disease, psychologic or not, allowed the patient: _ to become aware of the interferences of psychologic factors in the determination of his disease, _ to knowingly experience the threat which includes all internal “dissolving” _ and to furnish the therapist with all information about the history of his illness. These are the important components to guide the physician in the choice of a form of appropriate psychotherapy. 137.

BOOK VII Book VII consists of 7 chapters:

Chapter 59 : Irregular Circulation of Wei Energy (Wei Qi Zi Zhang) Chapter 60 : Inscriptions Engraved into Jade (Yu Ban)

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Chapter 61 : The Five Prohibitions (Wu Jin) Chapter 62 : Arterial Points (Dong Shu) Chapter 63 : Dissertation on the Five Sapors (Wu Wei Lun) Chapter 64 : Yin and Yang and the 25 Morphotypes (Yin Yang Er Shi Wu Ren) Chapter 65 : The 5 Musical Notes and 5 Sapors (Wu Yin Wu Wei)

no 138/139.

CHAPTER LIX Irregular Circulation of Wei Energy (Wei Qi Zi Zhang)

Chapter 59 of the Lingshu speaks on:

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_ the irregular circulation of Wei (defensive) energy, the cause of energetic stagnation at the level of the thorax and abdomen, resulting in numerous illnesses, _ and the treatment and choice of points. As diseases evolve differently as a function of etiology, the physician must base his judgment on morphology (fat or thin, big or small) and the age of the individual (young or old) in order to apply an appropriate therapy. Concerning morphology, this chapter describes 3 morphotypes as a function of the energetic and blood state (excessive or insufficient) of the individual: obese, fleshy and muscular. The illnesses studied in this chapter originate from energetic stagnation due to the nonconforming circulation of Wei (defensive) energy, hence the title: “Irregular Circulation of Wei Energy.” This chapter consists of 5 paragraphs.

PARAGRAPH 1 Huangdi: “When Wei (defensive) energy is retained within the stomach, it stagnates and does not circulate. This state, contrary to the rule, causes thoraco-abdominal fullness with dyspnea and energetic afflux toward the top. How can one abolish it?” 140.

Ba Gao: “In the event of accumulation of the energy within the thorax, one must needle the points located at the upper part of the body; in the event of accumulation of the energy within the abdomen, the points located at the lower part. In the event of accumulation at the same time above and below, one must needle the points located around these two regions.” Huangdi: “How do you needle them?” Ba Gao: “In thoracic accumulation, disperse: _ Daying (St 5) _ Tiantu (CV 22) _ and Huichong (other name for Lianquan-

CV

23).

In abdominal accumulation, disperse: _ Sanli (St 36) _ and Qijie (other name for Qichong- St 30).

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In thoraco-abdominal accumulation, disperse: _ the above-noted points and _ the point located 1 cun below the false ribs (Zhangmen-

Li

13).

• In the event of seriousness, needle according to the technique called Ge Zu (“claw of the pulse”) is recommended. But after needling, one must examine the pulse. If the pulse is changing (Da), tense (Xian) and hurried (Jin) or if the pulse does not arrive under the finger, needling is contraindicated.”

EXPLANATIONS AND COMMENTARIES I - Ma Shi explains:

“This paragraph speaks on the accumulation of the energy within the thorax and abdomen, responsible for numerous illnesses, and on the indications and contraindications of therapy. According to the Suwen: 141. “Wei, powerful energy originating from Shui Gu (Water-Cereals: foods), does not circulate in the channels, but in the epidermo-dermal spaces and at the level of Yuan Ma (fibrous, serous and mucous membranes; peritoneum, aponeurosis...) and spreads within the thorax and abdomen. As a result, the stagnation of Wei energy within the thorax or abdomen is an unusual phenomenon, contrary to the rule, hence the appearance of illnesses of the limbs, thorax and abdomen. Therefore, for example, thoraco-abdominal fullness is indicated by such clinical manifestations as dyspnea, energetic afflux toward the top... . How then do you treat it?” Qi Bo recommends: “1 - In the thoracic accumulation and Wei energy, it is advised to needle the points located at the upper part of the body: _ Daying (St 5), located 1.2 cun from the inferior maxillary angle, _ Tiantu (CV 22), located in a crease 4 cun below the pharynx _ and Lianquan (CV 23), located at the middle of the neck below the pharynx. Raise the neck to locate this point. 2 - In the abdominal accumulation of Wei energy, one must disperse: _ Sanli (St 36), located 3 cun below the knee, at the external edge of the tibia, in the middle of the large muscular mass between the two muscles _ and Qijie (Qichong- St 30), located 2 cun outside the anterior midline, on the femoral artery. 3 - In the thoraco-abdominal accumulation of Wei energy, one must needle the above-cited points: Daying (St 5), Tiantu (CV 22), Lianquan (CV 23), Sanli (St 36) and Qijie (Qichong- St 30) to which one adds the point Zhangmen (Li 13), located below the tip of the 11th rib. • In serious accumulations of Wei energy, one must employ the method of grouping together”of the needling called Ge Zu (claw of pulse). But before needling, one must carefully observe the pulse: _ if the pulse is changing, tense and hurried, it indicates the paroxysmal phase of the energy. One must wait for the calm phase to needle. _ if the pulse is exhausted, it indicates the shortage of energy. One must tonify it’.”

II - Zhang Shi states:

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“This paragraph gives dissertation on the production and circulation of Wei (defensive) energy which follows the Luomai (secondary vessels) of the Yangming to spread toward the top, bottom amd 4 sides of the body. When this energy is found blocked and accumulated in the thorax, it is necessary to needle Daying (St 5), Tiantu (CV 22) and Lianquan (CV 23) because these points are the sites of exit of the Wei energy toward the cutaneous system of the upper part of the body. 142. Similarly, when it accumulates within the abdomen, it is necessary to needle Qijie (St 30; Qichong) and Sanli (St 36) because these points are the sites of exteriorization of the Wei energy toward the cutaneous system of the lower part of the body. The Wei energy is a powerful energy originating from the Shui Gu (Water-Cereals: foods) whose metabolism is carried out at the level of the Stomach bowel. The Foot Yangming (St) channel unites: _ at the Renmai (CV) at the point Zhongwen (CV 12) to reach Chengjiang (CV 24) (see Figure 1) _ and at the Daimai (channel of the belt), at the left and right of the umbilicus, to link up to Qijie (St 30) located at the groin. Therefore, once metabolized, the Wei energy follows the Yangming (St) to become exteriorized at the cutaneous system. This is why, one needles the points noted above to treat diseases originating from the irregular circulation of Wei energy.” III - N.V.N.: 1 - This paragraph emphasizes the importance of the points by which the Wei energy exteriorizes to the exterior to control the epidermo-dermal, muscular and osseous systems of the upper and lower part of the body because, according to Chapter 68 of this classic (“Top of the Diaphragm”): “... the key point is to examine the state of the Wei energy because its insufficiency is the cause of “100 diseases”.”

2 - As for the technique called Ge Zu (foot of pulse), it is that described in Chapter 7 of this classic (“Use of the Needles”) under the name “Hegu Ci” (needling reproducing the angle found at Hegu- Li 4): “3 or 4 needles oriented toward the point of impact evoking the claw of a chicken. This type of needling must touch “the spaces of distribution of the flesh” (Xi and Gu: small valleys and valleys). This method treats Gu Bi (pain of the flesh: dermalgias). It responds to the spleen.” Ma Shi explains: “At the left as at the right, needling consists of several needles directed in a fashion in the pattern of a claw of a chicken, its depth not exceeding the “spaces of distribution of the flesh”. As the energy of the spleen controls the dermis (flesh), this method responds to the spleen organ.” In summary, “Hegu Ci” does not designate the needling of the point Hegu (LI 4). It is a general technique of needling: _ after having implanted the needle to a specific depth, lift it up slightly and place it permanently at the level of the dermis. With the aid of 3 needles, form the ideogram (fishes) that evokes the image of a chicken claw. 143.

_ specific technique in the treatment of Bi of the flesh (dermalgia). _ technique provoking reactive phenomena of the energy of the spleen because the spleen organ controls the system of connective tissues (flesh).

3 - Before needling, one must carefully examine the pulse because, according to Zhang Jing Yue: _ the changing, tense and hurried pulse is the sign revealing the emptiness of Yin _ the exhausted pulse which does not reach the fingers, associated with markdely tense abdominal skin is the indicator of escaping of the Ying energy.

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In these two cases, needling is absolutely contraindicated.

4 - We present below diagrams of points utilized in this paragraph.

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Figure 2

Figure 3

Points to needle in the case of accumulation of Wei (defensive) energy: _ Thoracic accumulation (Fig. 1) _ Abdominal accumulation (Fig. 2) _ Thoraco-abdominal accumulation (Fig. 3)

PARAGRAPH 2

144.

Huangdi: “Based on what criterion is a disease belonging to the skin and flesh, energy and blood, muscles and bones determined?” Bao Gao: “The appearance of a shiny and smooth color between the two eyebrows indicates disease of the skin. The appearance of a green, red, yellow or black color... at the lips heralds disease of the flesh. The excessive exhaustion of Ying (nutritive) energy at the exterior with humid skin and abundant sweating indicates disease of the blood and energy. The appearance of a green, red, yellow or black color... at the eyes heralds disease of the muscles. The appearance of a dusty and faded color at the ears is the sign revealing disease of the bones.”

EXPLANATIONS AND COMMENTARIES Ma Shi states:

“This paragraph gives dissertation on the method of determination of the disease of the skin and flesh, energy and blood, muscles and bones. _ In order to determine disease of the skin, one must examine the space located between the 2 eyebrows, that is to say, the point Jue Zhong (other name for Yintang- PC 3) belonging to the lung which governs the skin. A shiny and smooth appearance at the this level indicates a disease of the skin. _ In order to determine disease of the flesh, one must examine the lips because they respond to the spleen which governs the “flesh” (dermal) system. Therefore, the appearance of a green, red or black color... at the lips is the indicator of an attack of the flesh. _ In order to determine disease of the blood and energy, one must examine the energetic state of the Ying (nutritive energy). But the Ying is an energy, therefore invisible; this is why it is recommended to base one’s judgment on sweating to distinguish disease of blood and energy. _ In order to determine disease of the muscles, one must examine the eyes because the energy of the liver

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governs the muscles and exteriorizes at the eyes. _ In order to determine disease of the bones, one must examine the ears because the energy of the kidney governs the bones and exteriorizes at the ears.”

PARAGRAPH 3

145.

Huangdi: “What are these diseases and how are they treated?” Bao Gao: “The evolution _ the diseases _ the diseases _ the diseases _ the diseases Huangdi: “Please

clarify

of of of of of

the “100 Diseases” is immeasurable, but the skin have their zones of localization (Bu) the flesh have their zones of attachment (Zhu) blood and energy have their sites of circulation (Shu) the bones have their sites of association (Zhao). ”

for

me.”

Bao Gao: “• In diseases of the skin, it is advised to treat the external zone of the 4 limbs because: _ the skin is superficial _ the channels all begin at the tips of the fingers and toes. • In diseases of the flesh, it is advised to treat their zones of attachment because these are: _ the sites of distribution of the flesh where the Yang channels of the hand and foot circulate _ and the relatively thick sites where the Foot Shaoyin (Ki) pass. • In diseases of the blood and energy, it is advised to treat them at the level of the Luomai because the stagnation of the energy and blood can bring about a fullness of the Jingluo (principal and secondary channels) with phenomena of suffocation/accumulation (characterized by a visible and palpable swelling/upthrust). • In diseases of the muscles, one does not distinguish Yin and Yang, left and right. it is advised to only treat the affectd site. • In diseases of the bones, it is advised to treat their sites of association, that is to say, at the level of the articulations because the empty spaces of the articualtions are the sites of reception of synovial fluid, substance beneficial to the marrow and brain.” 146.

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Huangdi: “How do you needle them?” Bao Gao: “Diseases evolve to infinity. They can be localized in the interior or at the exterior of the body; needling must be deep or superficial. The therapeutic rules are numerous... . One must base one’s judgment on the location of the disease in order to apply an appropriate treatment. In benign diseases, needling is superficial, and in serious diseases, they necessitate the use of numerous needles. The regulation of the energy must be carried out as a function of the evolution of the disease. It is in this manner that the great workers (good doctors) practice.”

EXPLANATIONS AND COMMENTARIES I - Ma Shi clarifies:

“This paragraph completes the previous one and speaks on the therapeutic methods for diseases of the skin and flesh, blood and energy, muscles and bones. In order to determine the diseases of the skin, it is necessary to know their “localization” because they evolve toward the 4 limbs. In order to determine the diseases of the flesh, it is necessary to know their “sites of attachment” at the level of the arms and legs, that is to say, at the level of the 6 Yang channels of the foot and hand, and at the zones of the flesh belonging to the Foot Shaoyin (Ki). In order to determine diseases of the blood and energy, it is necessary to know their sites of circulation which are found at the Luo point of the channels because, when there is stagnation of blood and energy, there appears the phenomenon of swelling and thrusting up of this level. In order to determine the diseases of the muscles, it suffices to base one’s judgment on the region affected without needing to specify Yin or Yang, left or right. In order to determine the diseases of the bones, it is necessary to base one’s judgment on the “sites of their adherence”, that is to say, on the joints which are related to the marrow and brain.”

II - Zhang Shi specifies:

“Therapeutically, the points to choose are all found in the areas belonging to the skin and flesh, blood and energy, muscels and bones.”

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PARAGRAPH 4

147.

Huangdi: “The human body can be fat or thin, large or small, cold or hot. According to age, the individual can be old, adult, adoloescent or child. How do you classify them?” Bao Gao: “Above 50 years, man is called “Lao” (old man). Above 20 years, man is named “Zhuang” (adult). Above 18 years, man is called “Shao” (adolescent). Above 6 years, man is named “Xiao” (child). ” Huangdi: “How do you evaluate corpulence or thinness?” Bao Gao: “Man of marked corpulence is distinguished into 3 types: obese, fleshy and muscular”. Huangdi: “How do you differentiate these 3 types of men?” Bao Gao: “In the obese, the limbs are firm and flesh, quite full. In the fleshy, the muscles are firm and flesh, supple. In the muscular, the muscle adhere solidly to the skin”. Huangdi: “How do you explain the cold body and hot body?” Bao Gao: “In individuals possessing abundant fatty substance, the muscles are soft and lax, and “Cou Li” (adipose layer separating muscular masses) are coarse. This is why their body is cold, But if the Cou Li are fine and supple, their body is hot. 148.

In individuals possessing abundance of Chi (substance conserved within the bones; bony marrows), the muscles are hard and solid, and Cou Li, fine and supple. This is why their body is hot. In contrast, is Cou Li are coarse, their body is cold.”

EXPLANATIONS AND COMMENTARIES I - Ma Shi explains:

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“This paragraph speaks on the temperature of the body as a function: _ of the fatty substance (Gao) _ the medullary substance of the bones (Chi) _ and the state of the adipose substance separating the muscular masses (Cou Li).”

II - Zhang Shi adds: “The Cou Li designates the markedly crumbled adipose layer located between the fleshy masses.” III - N.V.N.: The definitions of Zhang Jing Yue are the following: _ in individuals of the “chi” type, the energy is strongly attached to the flesh. _ in individuals of the fleshy type, the energy and flesh are yielding. _ in individuals of the muscular type, the flesh is plated with muscles and the muscles adhere to the flesh.

PARAGRAPH 5 Huangdi: “How do you differentiate fat and thin, large and small?” Bao Gao: “In the fleshy, the energy is in abundance, and the skin is lax. This is why their belly is large and hanging. In the muscular, the body is of high stature (larger than in the fleshy). In the “Chi”, the body is of weak stature (smaller than in the muscular).” 149.

Huangdi: “What is the amount of energy and blood of these 3 types of men?” Bao Gao: “In the fleshy, the energy is in abundance; it gives much heat. This is why their hot body endures the cold so well. In the muscular, the blood is in abundance; it maintains the entire organism. This is why their body is harmonious. In the “Chi”, the blood is clear and energy very active but of small quantity. This is why their size remains small. These 3 types of men differ from the normal type.” Huangdi: “What is the normal type?” Bao Gao: “In normal individuals, skin and flesh, adipose substance (Gao) and medullary substance (of the bones = Chi) are equally formed. Their body is neither large nor small. This is why they are called “normal individuals”.

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Huangdi: “Good! How do you treat them?” Bao Gao: “One must first differentiate these 3 types of men and determine the insufficient or excessive state of their blood and the state of purity of their energy, and finally, apply the method of regularization according to the rules of the Jingmai (principal channels). In all the cases, one must grasp the reason for “ hanging belly” in the fleshy, “tall size” and “low size” in the muscular and the “inability to grow bigger” in the “Chi”.”

EXPLANATIONS AND COMMENTARIES I - Ma Shi clarifies:

“1 - In general, in the fleshy, the energy is excessive which renders the skin lax and causes the belly to fall. It is a matter of “fat” (obese) as opposed to thin. In the muscular, the body is well developed. It is a question of “large”. In the small possessing nuch “Chi”, their body is of weak stature. It is a question of “small”. 150.

2 - The fleshy contains much energy. The abundance of energy gives heat to their body that allows it to better endure the cold. The muscular contain much blood which spreads throughout the entire body which maintains a neither cold nor hot state. Individuals of “Chi” type contain pure blood and “active” (mobile) energy, but in small quantity, preventing the body from growing bigger, but having the same ability to endure the cold. Such are the 3 types of man which differs from normal individuals. 3 - In order to treat these 3 types, it is first necessary to determine the quantity and quality of blood and energy, then apply the method of regularization according to the rules of the Jingmai (principal channels). These 3 types of man are only fleshy, muscular and small.”

II - Zhang Shi clarifies:

“The excess of Wei (defensive) energy causes the “opening” of Cou Li (adipose layer between muscular masses). Therefore, in the fleshy, the energy is in abundance and the epidermo-dermal system of the subumbilical region is soft and lax, hence hanging belly. In the muscular, the body is of tall stature and well developed. This is due to the excess of Wei energy overflowing the region of distribution of the flesh. In the “Chi” types, the body is of small stature because the energy immerges deeply within the interior and is unable to exteriorize toward the adipose region, hence firmness and watertightness of the muscular masses. This is why the body is of weak stature and small.”

III - N.V.N.: The analysis of Zhang Shi permits comprehension of the fundamental role of the Wei (defensive) energy in 3 morphotypes: obese, fleshy and muscular. This chapter therefore emphasizes the necessity of understanding the formation of Wei energy in the

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treatment of diseases of energetic and endogenous origin. 151.

CHAPTER LX Inscriptions Engraved into Jade (Yu Ban)

Chapter 60 of the Lingshu demonstrates the etiology of tumor and the therapeutic rules, then the serious and fatal forms of “toxic” tumors deeply localized in the interior of the organism against which acupuncture is not indicated due to the presence of signs of discordance between the pulse and the disease. In this chapter, the needles are compared to very dangerous arms. If the little needles properly used can save the life of the patient, they are like instruments of war when they are used without reflection. Therefore, for example, needling the point Wuli (LI 13) can be harmful to the patient, causing a rapid depletion of blood and energy of the 5 organs, ending up in a brief delay of death. The object of this chapter is to furnish advice of vigillance to physicians during needling. Faced with the very precious nature of these recommendations, Huangdi orders Qi Bo to engrave them into jade in order to transmit them to future generations, hence the title: “Inscriptions Engraved into Jade (Yu Ban)”. Ma Shi notes, because of the phrase “... to inscribe into jade to make a precious object” contained in this chapter, the title is explained. Chapter 60 of the Lingshu contains 6 paragraphs.

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PARAGRAPH 1

152.

Huangdi: “I have always thought of the needles as miners’ instruments, and you say that, above, they respond to Heaven, below, to Earth, and at the middle, to Man. I fear that you exaggerate their greatness. Do you wish to give me an explanation?” Qi Bo:

“Do objects exist that are larger than Heaven?

Among the instruments greater than the little needles exist only the “5 types of arms” (Wu Bing) intended to kill and not to safeguard life. Furthermore, man, being precious, belonging to Heaven and Earth, can only participate in activities of the natural world. Therefore, the Dao (principles, rules) of government of the people is similar to the methods of utilization of the needles; between them and the “5 types of arms”, which are of lesser size?”

EXPLANATIONS AND COMMENTARIES I - Ma Shi explains: “This paragraph speaks about the concordant nature of the little needles and the “Three Powers” (San Tai: Heaven-Earth-Man) from the fact that their very high use is related to that of the “5 types of arms”. These arms, certainly quite imposing, are only aimed to kill, while the needles, although small, are instruments for the safeguarding of life. In this manner, the needles have the characteristic of being concordant with the “Three Powers”. As a result, one cannot consider them “little”.”

II - N.V.N.: This paragraph stresses the problem of the legitimate role of the needles of acupuncture involving the Universal Dao. In Chapter 38 (1) of this classic (“Contrary and Favorable. Fat and Thin”), Huangdi therefore questions Qi Bo: “The use of the “9 Needles” as a function of their name and their number, beginning with 1 and ending with 9, certainly have another more profound meaning which escapes me. Therefore, I have still not clearly grasped its true Dao (principles, rules) because, in the Dao of acupuncture, among the “9 Needles”, _ the little ones cannot go to the depths, _ the large ones cannot remain at the surface, _ the deep is like the core not being perceived _ the top (surface, superficial) is such that it cannot be covered... . This is so subtle and penetrating, so vast and immense, that one cannot know the end. I know that all this conforms with the Dao of the modification/transformation of Heaven and Earth and of “human affairs”. But, faced with the complexity of the problem, I would like to gather all this dense (like hair) information in order to establish a recapitulative diagram of the whole. Is this possible?” 153. 1. See Lingshu, Volume II, N.V.N. Edition.

In Chapter 45 of this same classic (“Evaluation of the Exterior”), it is also said: “The Dao of the sages is founded on the observation of the top, which responds to Heaven (astronomy), the bottom, which represents the Earth (geology) and to the middle, which corresponds to “human affairs” , according

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to precise rules of measurement and the particular method of calculation, in order to be transmitted to future generations... .” According to Zhang Jing Yue: _ The “Wu Bing” (Five Arms) used in the time of Huangdi are: large knife, sword, spear, bow and lance. _ These 5 types of arms give death, while the little needles treat diseases and safeguard the life of the people. _ In the “Heaven/Earth” space, man is the most precious. In order to rescue him from disease, the needles have effects responding: • at Heaven, to Yang • at Earth, to Yin • and at the middle, to man. In summary, the needles have the role of joining together the San Tai (3 Powers) of the human being.

PARAGRAPH 2 Huangdi: “Some illnesses start via an alternation of joy and anger or via a digestive disorder which causes: _ an insufficiency of Yin energy of the 5 organs and an excess of Yang energy of the 6 bowels with stagnation of Ying (nutritive) energy, causing the formation of Yung (abscess) and Ju (tumors), _ or a blockage of blood and energy with confrontation of 2 heats (endogenous and exogenous), the origin of pyogenic production. Can one cure these diseases with the little needles?” Qi Bo:

“When perverse energy infiltrates deeply within the body, it causes serious disease. Even the Sage (good physician) usually finds such disease difficult to cure. In every case, its goal is to eliminate as quickly as possible this perverse energy. 154.

In this domain, when two armies, in order to battle, wearing standard claquant au vent, swords and lances, are lined up in the center of the plain, the cause of the conflict is already old. It is the same for a country whose people obey the rules and soldiers, respecting authority, abide by the rules. The establishment of the law is not done in one day or several hours. In man, the appearance of abscesses and tumors is generally due to negligence in the practice of the Dao of Eugenism (Yang Sheng). The formation of abscesses ( Y u n g ) and tumors (Yu), the production of purulent blood does not descend from Heaven and does not suddenly appear from Earth. They stem from minor accumulated and repeated consequences of harmful energy evolving in a chronic fashion to end up being serious. This is why, the Sage treats disease before it forms, and the ignoramus only deals with it after its appearance.” Huangdi: “The formation of Yung (abscesses) and Yu (tumors) can arise unnoticed, and the production of pus is generally invisible. What is the course of action to take?”

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Qi Bo:

“After the formation of pus, the mortality is 9 out of 10. This is why, the Sage treats what has not yet formed and elaborates the therapeutic rules which he inscribes onto bamboo tablets in order to transmit them, continuously, to future generations.” EXPLANATIONS AND COMMENTARIES I - Ma Shi explains:

“This paragraph speaks on the blood and energy located at the epidermo-dermal part, circulating from the interior toward the exterior, the least stagnation of which progressively causes the formation of pustules. If these pustules localizing at the exterior are of small size, cure is rapid. In contrast, if abscesses accumulate in the interior, the disease is grave with 10 risks of defeat against one chance of survival. • “Excess of joy or anger and digestive disorder” are classed among the internal causes of disease. This is why the above-cited pustules are not of “Wind, Cold, Heat or Humidity” etiology of Heaven and Earth, but caused by little chronic accumulations of blood and energy which progressively provoke disease. This disease can be compared to a confrontation of two armies whose cause is not dated from several days. Therefore, the sage wait neither for the formation of pustules nor pyogenic production to work out the therapeutic rules in order to inscribe them onto tablets of bamboo. These are intended for future generations, but also for those who wish to consult them. These rules are named the “10 risks of death to one chance of life”. 155.

• “Pustules” designate lesions of the skin formed by a circumscribed uprising of the epidermis containing purulent liquid. The pustules can be of malignant nature. They start via a small vesicle filled with serous fluid whose base rapidly becomes indurated at the level of which a gangrenous plaque forms which is encircled by an inflammatory zone.”

II - N.V.N.: Chapter 81 of this classic (“Abscesses and Tumors”) is entirely devoted to the study of Yung (abscess) and Yu (tumor).

PARAGRAPH 3 Huangdi: “When the suppuration is advanced and it passes into the blood, the prognosis is very poor. Is treatment via the little needles still possible?” Qi Bo:

“In the In the This is Long (needle

treatment of little abscesses by little needles, the effect is reduced. treatment of large abscesses by large neeldes, the effect is harmful. why, in the presence of a purulent formation, lithopuncture and Ti No. 5 with sword tip) are judiciously recommended.”

Huangdi:

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curb

“The evolution of abscesses and tumors is often harmful. Does a means exist to it?”

Qi Bo:

“The key point is to base one’s judgment on the “ c o n t r a r y ” nature and “ f a v o r a b l e ” nature of the disease.” Huangdi: “I would like to know what you mean by “ c o n t r a r y ” and “ f a v o r a b l e ” ? ” Qi Bo:

156.

“In the patient, _ the appearance of greenish color at the white of the eye (cornea) and the contraction of the black of the eye (iris) are the first signs of “ c o n t r a r y ” . _ vomiting after absorption of medication, the second sign of “ c o n t r a r y ” . _ abdominal pains and thirst, the third signs of “ c o n t r a r y ” . _ cervical stiffness associated with a blockage of the shoulder, the fourth sign of “ c o n t r a r y ” . _ hoarse voice with pale white facies, the fifth sign of “ c o n t r a r y ” . Signs aside from these “ c o n t r a r y ” are called “ f a v o r a b l e ” . ” EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains:

“Use of the little needles to treat small abscesses usually provokes a simple medical action whose effectiveness is always assured. In contrast, use of long needles to treat large abscesses usually provokes a contrary afflux of the energy generally ending up in death. This is why, in the case of large abscesses, it is recommended to use lithopuncture or needles of the Fi Long (No. 5) type. • Large abscesses are grouped into: _ favorable abscesses: the disease evolves toward the exterior (skin, flesh, muscles, bones). This is life. _ contrary abscesses: the disease evolves toward the interior (5 organs). This is death. When they evolve toward the interior, the organs are injured and the contrary signs are: 1 - Green color of the conjunctiva and shrinkage of the pupil: signs of attack of the energy of the 3 organs, lung, liver and kidney. 2 - Vomiting after taking medications: signs of weakening of the energy of the stomach. 3 - Abdominal pains and thirst: signs of the exhaustion of the energy of the spleen because it controls the circulation of organic liquid and aids the stomach in fulfilling its functions. 4 - Blockage of the shoulder and neck stiffness: signs of disturbance of the Yang energy because the Taiyang is “master” of all the Yang channels. 5 - Hoarse voice: sign of attack of the energgy of the heart because the heart organ governs speech. Generally, contrary signs of abscesses are fatal. Their elimination permits survival.”

II - Ma Shi comments: 157. “”Eyes”, external orifices of the liver, belong to the 5 organs because 1 - The conjunctiva (white part) correspond to the lung. It turns green via the phenomenon of transgression of perverse energy of the liver occuring in the region called “non victorious” (normally, LungMetal inhibits Liver-Wood; or here, it is the opposite), due to the insufficiency of the energy of the lung. When the pupil (black part) contracts, this denotes an insufficiency of the energy of the kidney.

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2 - Vomiting after medication ingestion indicates an insufficiency of the energy of the spleen. 3 - Abdominal pains denotes a fullness of the energy of perverse energy, and thirst, heralds disturbance of Fire. 4 - The shoulder belongs to the 3 Yang of the hand, and the nucha, to the 6 Yang (foot and hand) and to the Dumai (GV). If the movements of the shoulder and nucha are restricted, this is due to the fullness of Yang and emptiness of Yin. 5 - The hoarse voice originates from the insufficiency of the energy of the lung and heart. Pale white color is due to the insufficiency of the energy of all 5 organs. Such are the “contrary” signs associated with abscesses.”

III - N.V.N.: A - According to Chapter 21 (paragraph 21) of this classic (“Diseases of Heat and Cold”) (2), death is inevitable when the abscess (anthrax) manifests in one of the following 5 regions: 1 - Region of Futu (St 32), point belonging to the Foot Yangming, 6 cun above the knee. 2 - Calf region where the point Zhicheng (Bl 56) is found which is prohibited from being needled. But moxabustion is advised. 3 - Midline region of the back where the Dumai (GV) is found. 4 - Region of the Back Shu points, like Feishu (Bl 13), Shenshu (Bl 15), to the side of and below the 3rd dorsal vertebra, Pishu (Bl 20) to the side of and below the 11th dorsal vertebra, etc. 5 - Nuchal region belonging to the Dumai (GV) and Taiyang (Bl). 2. See Huangdi Neijing Lingshu, Volume I, N.V.N. Edition.

Zhang Shi clarifies: “Abscesses can be of Wind-Cold origin coming from the exterior or following an internal perturbation of psycho-affective (internal) origin. They can also originate from a digestive disorder or a disequilibrium of Ying (nutritive energy) oor of Wei (defensive energy). In all the cases, Yin and Yang lose their connection, hence confrontation of “2 Heats” with pyogenic formation. 158.

Sometimes, these abscesses manifest on the arms and are fatal; sometimes, they manifest on the back or nucha and are curable. Therefore, one must determine the benign or malignant nature of these abscesses, and the emptiness and fullness of the essential energy to evaluate the prognosis of life or death. If these abscesses are of exogenous etiology, the good physician first treats the skin, then the flesh and the muscles. If it is a question of endogenous origin, he evacuates the “stagnant” energy toward the cutaneous system avoiding it becoming inflammatory. In other words, at the starting phase, the abscesses of these 5 regions are curable, and in the phase evolving toward pyogenic formation, they are incurable.” B - The eyes are the “external orifices” associated not only with the liver but also with the 5 organs. In effect, according to Chapter 74 of this classic (“Dissertation on Diseases and the Examination of the Skin of the Forearm”): “A red conjunctiva is the indicator of an attack of the heart; white, that of the lung; green, that of the liver; yellow, that of the spleen; black, that of the kidney; neither red, nor yellow, but orange, the thorax. Capillaries of descending trajectory are the indicator of disturbance of the Taiyang (SI and Bl); those of the ascending trajectory are the indicator of disturbance of the Yangming (LI and St); those of external-internal direction are the indicator of disturbance of Shaoyang (SJ and GB)... .” (Figure 1) According to this assertion, one can conclude that examination of the color of the eyes constitutes a significant contribution to diagnosis in Chinese energetic medicine.

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PARAGRAPH 4

Figure 1 159.

Huangdi: “All diseases possess “ c o n t r a r y ” signs and “ f a v o r a b l e ” signs. How do you know them?” Qi Bo:

“_ Abdominal bloating, hot body (fever) and changing (Da) pulse are associated with the 1st “contrary” syndrome. _ Boborygmi, abdominal fullness, cold of the 4 limbs and changing (Da) pulse, with the 2nd “ c o n t r a r y ” syndrome. _ Continuous epistaxis and changing (Da) pulse, to the 3rd “contrary” syndrome. _ Cough, hematuria, weight loss and small and resistant pulse, to the 4th “ c o n t r a r y ” syndrome. _ Cough, weight loss, hot body (fever) and small and hurried pulse, with the 5th “ c o n t r a r y ” syndrome. In the presence of these syndromes, death follows at the end of 15 days.”

EXPLANaTIONS AND COMMENTARIES I - Zhang Shi explains:

“This paragraph speaks on the fatal outcome in 15 days in cases of chronic stagnation of blood and energy at the level of the Jingmai with pyogenic formation. If these activities of the 5 organs are distorted by a contrary state (to the law of the 5 Movements), death can take place before abscesses form.

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Therefore, 1. “Abdominal bloating, fever and changing pulse” denopte a contrary stste of the spleen. 2. “Boborygmi and bloating, cold of the 4 limbs and changing pulse” indicate the contrary state of the kidney. 3. The liver conserves the blood. “Continuous epistaxis” is the indicator of a contrary state of the liver. 4. The lung is the site of residence of the “100 vessels” before they reach the pilo-cutaneous system. “Cough, hematuria, weight loss and the small and resistant pulse” indicate therefore a contrary state of the lung. 5. The heart governs the blood and vessels, and the lung “covers” it. “Cough, weight loss, fever and the small and hurried pulse” denotes therefore a contrary state of the heart. The blood and vessels originate from the 5 organs. In the event of contrary circulation, the 5 organs can no longer fulfill their function and their source energy is disturbed. This is why death occurs at the end of 15 days.”

PARAGRAPH Qi Bo:

5

“The other 5 “contrary”

160.

syndromes of acute and lethal nature are therefore:

1. “Excessive swelling of the abdomen, cold of the 4 limbs, weight loss and marked diarrhea” are associated with the first lethal c o n t r a r y syndrome. 2. “Excessive swelling of the abdomen, melena and changing (Da) pulse with s t o p p a g e ” are associated with the second lethal contrary s y n d r o m e . 3. “Cough, hematuria, weight loss and resistant pulse” are associated with the third lethal c o n t r a r y syndrome. 4. “Hematemesis, thoracic oppression with radiation to the back and small and hurried pulse” are associated with the fourth lethal contrary s y n d r o m e . 5. “Cough, nausea and vomiting, excessive swelling of the abdomen and postprandial diarrhea with exhausted pulse” are associated with the fifth lethal c o n t r a r y syndrome. In the presence of these syndromes, death takes place at the end of one day. Physicians who needle without taking into account these “contrary” signs practice a “contrary” t h e r a p y . ”

EXPLANATIONS AND COMMENTARIES I - Ma Shi explains:

“All diseases possess “contrary” signs and “favorable” signs. Some diseases, presenting contrary signs, provoke death at the end of 15 days, and others presenting also with contrary signs cause death at the end of a day. 1. The 5 contrary syndromes causing death at the end of 15 days are the following: a - “Abdominal bloating, fever and changing pulse” denote a state of fullness of perverse energy. b - “Boborygmi and abdominal bloating, cold of the 4 limbs and diarrhea” are Yin signs and the changing

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pulse is Yang. it concerns then a Yin syndrome with a Yang pulse. c - “Continuous epistaxis” is a Yin symptom and the changing pulse is Yang. it also concerns a Yin syndrome with Yang pulse. d - “Cough above, hematuria below, weight loss” indicate an exhaustion of the essential energy, and the small and resistance pulse denotes the non-regression of perverse energy. e - “Cough, weight loss, hot (fever) body” herald an insufficiency of the essential energy with fullness of perverse fire, and the small and hurried pulse also denotes the non-regression of perverse energy. 161.

In the presence of these “contrary” syndromes, death takes place at the end of 15 days.

2. The other 5 lethal “contrary” syndromes causing death in 1 day are: a - “Excessive swelling of the abdomen, cold of the 4 limbs, weight loss and marked diarrhea” are the signs associated with the 1st lethal contrary syndrome. b - “Excessive swelling of the abdomen in the interior and intestinal hemorrhage below” are associated with a Yin syndrome. The changing pulse is Yang. The changing pulse with stoppage is a fatal pulse. These signs are associated with the second lethal contrary syndrome. c - “Cough above, hematuris below and weight loss” are the signs of fullness of Fire and emptiness of Water. Moreover, the pulse is resistant... . These signs are associated with the third lethal contrary syndrome. d - “Hematemesis, fullness and abdominal pain with radiation toward the lumbar region and small and hurried pulse” indicate the emptiness of Yin with fullness of Fire. These signs are associated with the fourth lethal contrarysyndrome. e - Cough and vomiting above, abdominal swelling in the middle and diarrhea” denote the seriousness of the disease characterized by an exhausted pulse. These signs are associated with the fifth lethal contrary syndrome. In the presence of these syndromes, death occurs in 1 day.”

III - N.V.N.: We present below a summary table of contrary syndromes of Yung-Yu (abscesses-tumors) and other diseases.

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Contrary Syndromes

Contrary aspects of Yung-Yu evolving toward the organs

Contrary aspects of diseases: discordance between pulse and signs

Contrary aspects of the lethal syndromes

1st contrary syndrome

_ greenish conjunctiva _ shrinkage of the pupil (m,yosis)

_ abdominal bloating _ hot body (fever) _ changing pulse

_ excessive bloating _ cold of the 4 limbs _ weight loss _ marked diarrhea

2nd contrary syndrome

_ vomiting after taking medications

_ Boborygmi _ abdominal fullness _ cold of the 4 limbs _ changing pulse

_ excessive bloating _ melena _ changing pulse with pause

_ abdominal pains _ thirst

_ Continuous epistaxis _ changing pulse

_ cough _ hematemesis _ weight loss

_ cervical stiffness _ blockage of the shoulder

_ cough _ hematuria _ weight loss _ small and resistant pulse

_ hematemesis _ thoracic oppression _ small and hurried pulse

3rd contrary syndrome

4th contrary syndrome

5th contrary syndrome

_ hoarse voice _ pale white facies

_ Cough _ weight loss _ hot body (fever) _ small and hurried pulse

_ cough _ nausea and vomiting _ excessive swelling of the abdomen _ post-prandial diarrhea _ exhausted pulse

PARAGRAPH 6

162.

Huangdi: “Master! You have spoken with extraordinary effectiveness of the needles which can to be compared to Heaven and Earth. Above, they respond to astronomy, and below, to geomancy; in the interior, they link up with the 5 organs, and at the exterior, they respond to the 6 bowels. The Jingmai form a reunion of 28 vessels circulating following very specific rules. Acupuncture can kill, but it cannot resuscitate the dead! Would the Master say otherwise?” Qi Bo:

“Effectively, if one ignores the rules of needling, the needles can kill patients instead of curing them.” Huangdi: “Your words greatly disturb me. Please tell me why the manifestation of the needles can have so harmful an effect.”

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Qi Bo:

“The reason is quite simple. Those who fail to appreciate the art of the needles can be compared to a murderous criminal with his sword or an alcoholic in an intoxicated state. Examination is not necessary in order to know the cause.” Huangdi: “Please

give

me

more

information”

163.

Qi Bo:

“Man has his energy as a result of the cereals (Gu). The cereals release their energy as a result of the stomach. Therfore, the stomach is the “sea” of the Water-Cereal (Shui Gu), of Blood-Energy (Xue-Qi). The sea is the site of emission of the clouds traveling throughout Heaven, and the stomach is the site of production of blood and energy flowing within the Jing Sui (“impeccable, perfect channels”) . The Jing Sui are the large circulatory routes (Dai Luo) belonging to the 5 organs and 6 bowels. If one uses the method known as “to go against to eliminate” , the Qi (energy) will rapidly be exhausted.” Huangdi: “Are there forbidden points at the level of the channels of the foot and hand?” Qi Bo:

“If one applies the method known as “to go against to eliminate” at the point Wuli (LI 13), the energy of the body becomes exhausted during manipulation of the needle. If one repeats, erroneously, the dispersion 5 times, the energy of one organ will be exhausted. If one repeats, eroneously, the dispersion 5 X 5 = 25, the energy of the 5 organs will totally be destroyed. To act in this manner is to eliminate the energy of the “Celestial Source” (Tian Shen) thereby cutting short the life of the patient. Therefore, this death comes from ignorance of the “forbidden points” and not because the needles kill... .” Huangdi: “The rules of needling that you have submitted to me are invaluable. Please inscribe them into jade, mentioning the “Forbidden Points” of acupuncture, so they may be transmitted to future generations. Therapeutic errors can therfore be avoided.”

EXPLANATIONS AND COMMENTARIES I - Zhang Shi describes:

“1 - This paragraph speaks on the relationship of the little needles with San Tai (3 Powers: Heaven-Earth-Man). 164. In man, these needles aerate the jingmai, regulate the blood and energy and transmit the contrary and favorable movements at the level of the points of reunion. These notions of great truth are inscribed in jade in

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order to transmit them to future generations. Physicians who poorly assimilate the Dao of the San Tai go against the circulatory functions of the blood and energy and provoke great harm even more terroble than arms that kill. 2 - Dai Luo designates the “Distinct Luo” or “Luo Bie” belonging to the 12 principal channels. The point Wuli (LI 13) is located 3 cun above Quchi (LI 11). Because the Dai Luo of the 5 organs and 6 bowels are in relation with the Jingmai (principal channels) to diffuse to the 4 limbs, the Dai luo (Longitudinal Luo) (3) of the Hand Yangming (LI) and its principal channel (Hand Yangming - LI) connect at the point Wuli (LI 13) before disseminating to the skin. • The organ is Yin in relation to the bowel which is Yang. The channels are Yin in relation to the skin which is Yang. The Hand Yangming (LI) is the “bowel” of the Hand Taiyin (Lu). As a result, due to the energy of the stomach, _ the blood and energy of the 5 organs circulating within the vessels (Mai) reach the Hand Taiyin (Lu) in order to respond to the “Chi” (foot”) and “Cun” (inch) pulses. _ the blood and energy of the 5 organs circulating outside the the vessels (Mai) reach the Hand Yangming (LI) in order to respond to the cutaneous system. This is why, if the pulse is huuried, the Chi (foot) area is also hurried; if the pulse is late, the Chi (foot) area is also late. Therefore, when one carefully examines the Chi (foot), it is useful to examine the Cun (inch). • “To go against” is to go in front of the energy that arrives to stop it, and “to go in pursuit” is to pursue the energy that comes to leave. This is why, _ to needle the energy that arrives 5 times is to obtain all the energy of the 5 organs _ to needle the energy which comes to leave 5 times is to induce the energy to escape _ and to needle the 25 Shu (antique) is to empty the energy of these “Shu”. 3. In 1969, with Chamfrault, we translated them as “Longitudinal Luo”; see MTC, NVN edition.

The loss of the energy is therefore the cause of death. This is not the fault of Heaven, but murder committed by man. Consequently, 165. _ needle at the “threshold of the door” (superficial puncture of a forbidden point) and death will take place in the house (in the patient) (4) _ and deeply needle the “door” and death will take place on the spot (in the physician’s office). Faced with this danger, Huangdi will order Qi Bo to inscribe it in jade under the title “Forbidden Needling”.

II - N.V.N.: I. 1. Acupuncture is contraindicated in certain particular pathophysiologic and psychologic states: _ anger and frightful states _ drunken states, youth, exhaustion after severe or prolonged physical exertion. Debility and a poor general state impose particular precautions in needling. 2. The pregnant state merits special note: _ during the first 3 months, the lower abdominal region is prohibited from being needled _ after these 3 months, it is prohibited to needle the upper abdominal, lumbar and gluteal regions and points susceptible to provoke live reactions (see “Da Cheng”, below). 3. The previous history of miscarriage in a patient presenting with a generally deficient state represents an absolute contraindication.

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4. In children, the cephalic region is prohibited from being needled. 5. According to the Neijing, there are 26 energetic points which must not be needled deeply. This restriction is justified by the existence of vital organs or large underlying vessels and by proximity to sense organs. Therefore, it is prohibited for novices to practice deep needling on the points: 1) Shou Wuli (LI 13) 2) Chengqi (St 1) 3) Ruzhong (St 17) 4) Quchong (St 30) 5) Jimen (Sp 11) 6) Quingling (He 2) 7) Luoque (Bl 8) 8) Yuzhen (Bl 9) 9) Chengjin (Bl 56) 10) Lingxu (Ki 24) 11) Sanyangluo (SJ 8) 12) Luxi (SJ 19) 13) Jiaosun (SJ 20)

14) Wangu (GB 12) 15) Changling (GB 19) 16) Yuanye (GB 22) 17) Jimai (Li 12) 18) Zhongshu (GV 7) 19) Naoshu (GV 17) 20) Xinhui (GV 22) 21) Shenting (GV 24) 22) Shendao (GV 11) 23) Huiyin (CV 1) 24) Shenque (CV 8) 25) Shuifen (CV 9) 26) Shanzhong (CV 17)

166.

The use of these points therefore necessitates particular precautions. In practice, one can resort to oblique or less deep punctures. 4. Note that the word “door” used in enegetic medicine of Huangdi’s era was only employed in Western Scientific Medicine from the 20th century (the “Gate Control” theory of Melzac and Wall).

• We note below the “points prohibited from being needled” mentioned in the Zhen Jiu Da Cheng (5):

a) Points prohibited from acupuncture are: Naoshu (GV 17) Xinhui (GV 22) Shenting (GV 24) Yuzhen (Bl 9) Luoque (Bl 8) Chenling (GB 18) Luxi (SJ 19) Jiaosun (SJ 20) Chengqi (St 1) Shendao (GV 11) Lingtai (GV 10)

Shanzhong (CV 17) Shuifen (CV 9) Shenque (CV 8) Huiyin (CV 1) Henggu (Ki 11) Qichong (St 30) Jimen (Sp 11) Chengjin (Bl 56) Sanli (LI 10) Sanyangluo (SJ 8) Quingling (He 2)

b) Points prohibited during pregnancy Hegu (LI 4) Sanyinjiao (Sp 6) Shimen (CV 5) c) Points susceptible to provoke fainting: Yunmen (XB 2) Jinwei (CV 15) Quepen (St 12)

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167.

Jianjing (GB 21) e) The needle touching the 5 organs or making Chongyang (St 42) bleed can cause death. Also classed among the prohibited points are: Haiquan (PC ? ), located in the sublingual region Quanliao (SI 18), etc.

5. “Art and Practice of Acupuncture and Moxabustion of Yang Chi Chou (1522-1620 A.D.), N.V.N. Edition.

II. Points prohibited from moxabustion are also cited in the Da Cheng:

Yamen (GV 15) Fengfu (GV 16) Tianshu (Bl 10) Chengguang (Bl 6) Linqi (GB 41) Touwei (St 8) Jingming (Bl 1) Zanzhu (Bl 2) Suliao (GV 25) Heliao (SI 19) Yingxiang (SI 20) Qianliao (SI 18) Xiaguan (St 7) Renying (St 9) Tianyou (SJ 16) Shaofu (He 8) Yuanye (GB 22) Ruzhong (St 17) Jinwei (CV 15) Quchai (Bl 4) Jianzhen (SI 9) Yangchi (SJ 4)

Zhongchong (XB 9) Shaochang (Lu 11) Yuji (Lu 10) Jingqu (Lu 8) Diwuhui (GB 42) Yangquan (GB 33) Yao Yangquan (GV 3) Jizhong (GV 6) Yinbai (Sp 1) Lougu (Sp 7) Yinling (Sp 9) Tiaokou (St 38) Dubi (St 35) Yinshi (St 33) Futu (St 32) Biguan (St 31) Shenmai (Bl 62) Weizhnong (Bl 40) Yinmen (Bl 37) Chengfu (Bl 36) Baihuanshu (Bl 30) Xinshu (Bl 15).

III. The Da Cheng also raises the problem of “Meeting-Pursuit”

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168.

This is a means of supply and of capturing the energy by implantation of the needle. 1 - In the first place, it is indispensible for understanding the movements of the Ying energy and Wei energy: _ Yang channels circulate to the exterior of the energetic circuit; the Luo Yang, in the interior. 169.

_ Yin channels circulate in the interior of the energetic circuit; the Luo Yin, at the exterior. In short, these Jingluo differ according to their depth. The technique of needling is the following: a - One implants the needle to “one depth” of the energetic layer to reach the Ying energy, to “two depths” to reach the Wei energy. At each depth, one performs a stopping movement to wait for the Deqi. b - At the moment of the arrival of the energy, one transmits to the needle a retreating movement in order to guide it; this movement is called “Maneuver of Meeting”. c - At the moment of departure of the energy, one transmits to the needle an advancing movement in order to follow it; this movement is called “Maneuver of Pursuit”. These acupuncture techniques are illustrated by these phrases: _ “Agitate, retreat and receive...”, “meet and capture...”, “orient to the left...” are movements intended to disperse in light of coolong what is heated up. _ “Push in well, advance and turn...”, “pursue and bring forth...”, “orient to the right...” are movements intended to tonify in light of heating up what is cooled down. 2 - Finally, one must have present in mind the sites of departure and arrival of the Jingluo: _ the 3 Yang channels of the foot going from head to foot _ the 3 Yin channels of the foot leaving from the foot toward the thoraco-abdominal region _ the 3 Yin channels of the hand leaving the thorax to reach the hand _ the 3 Yang channels of the hand going from hand to head. During needling, once the Deqi is obtained, one orients the point of the needle in the direction opposite to that of the circulation of the Jingmai to execute the “Technique of Meeting” and in the same direction to execute the “Technique of Pursuit”. The Neijing has said justifiably: “In the event of fullness, one must block in order to stop. In the event of emptiness, one must bring forth in order to support.”

3 - Concerning the “technique of needle implantation”, first, one looks for the point to needle with the left hand and, with the fingernail, one flattens out the entire site by rubbing to disseminate the blood and energy; in the case where one has made the point bleed, one avoids this pressure. Second, from the right hand, one poses the point of the needle and asks the patient to cough while driving the needle in well toward the left and toward the right up to the dermis. This technique involves needling the Yang area responding to the odd number. As for needling the Yin area corresponding to the even number, “The Essentials of Acupuncture” states: 170.

“One depth from the energetic layer is associated with the Ying zone. During the needling, it is necessary to provoke a “Suspended Yang” before employing the technique of “InspirationExpiration”, then one advances the needle up to the dermis, all en sachant measuring the depth in inches (cun)”. Then it adds: “Two depths from the Ying layer is associated with the Wei zone. During fullness, one must remain in the zone of “Suspended Yang” just as in the zone of “Double Wei” (Er Wei) and one must have clear-sightedness to evaluate the persistence or disappearance of the disease. With the left hand, one massages the point in order to render it stable as if one mimics the “Apparent Repose” of Earth; with the right hand, one holds the needle as of one mimics the “Apparent Movement” of Heaven.

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As soon as the Deqi is obtained, with the left hand one massages the point exercising a strong pressure of about 1.5 kg.; with the right hand, one shakes the needle to achieve the technique of “Tonification-Dispersion”. Among acupuncture points, only the Shu points extending in width are visible and hard to the touch. Needling the channels must be done according to the rule of “Meeting-Pursuit”. To avoid bleeding, one must press on the point, massaging it immediately upon removal of the needle. Superficial of deep needling can cause an “Ill of acupuncture (fainting). It is necessary then to immediately stop the action. Tonification and dispersion are always performd as a function of dietary energy.”

171.

CHAPTER LXI The 5 Prohibitions (Wu Jin)

Chapter 61 of the Lingshu speaks on the definition of the _ _ _ _ _

“5 Prohibitions” (Wu Jin) “5 Exhaustions” (Wu Dua) “5 Excesses” (Wu Guo) “5 Contraries” (Wu Ni) “9 Indications” (Jiu Yi) (1)

among which the “5 Prohibitions” are taken for the title of this chapter. The “5 Prohibitions” designates the 5 days that needling of certain regions of the body is prohibited. The “5 Exhaustions” apply to a great emptiness of the essential energy for which dispersion is prohibited.

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The “5 Excesses” concern the limits of tonification and dispersion to never overstep. The “5 Contraries” designates the discordance between the pulse and signs during which needling is absolutely advised against. The “9 Indications” are not addressed here because they are developed in the chapter “9 Needles” of this classic. This chapter consists of 4 paragraphs.

1. Cf. Chapter 78 (“Dissertation on the 9 Needles”).

PARAGRAPH 1

172.

Huangdi: “I have heard something about the “5 What are these prohibitions?” Qi Bo:

“It

concerns

the

days

needling

is

prohibited.”

Huangdi: “I have heard something about the “5 Qi Bo:

Prohibitions” (Wu Jin) of acpuncture.

Exhaustions” (Wu Dua).”

“Dispersion is strictly advised aganist in diseases forbidden to be needled”.

Huangdi: “I have heard something about the “5 Excesses” (Wu Guo).” Qi Bo:

“Tonification and dispersion must not exceed their limit.”

Huangdi: “I have heard something about the “5 Contraries” (Wu Ni).” Qi Bo:

“The discordance between signs and pulses is a contrary state.”

Huangdi: “I have heard something about the “9 Qi Bo:

Indications” (Jiu Yi).”

“To delve very deeply into the theory of the “9 Indications”.”

Needles” is to know the “9

EXPLANATIONS AND COMMENTARIES

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I - Zhang Shi explains:

“This paragraph completes the previous one via the study of the “5 Prohibitions”, “5 Exhaustions”, “5 Excesses”, “5 Contraries” and the “9 Indications”.

II - N.V.N.: The theory of the “9 Needles” is shown in Chapter 1 of this classic (“9 Needles and 12 Yuan”). In regard to the “5 Excesses”, Zhang Jing yue specifies: “Excessive tonification maintains the perverse energy and excessive dispersion exhausts the essential energy.”

PARAGRAPH 2

173.

Huangdi: “What is the meaning of the Wu Jin (5 Prohibitions) ? Please inform me of the days acupuncture are prohibited.” Qi Bo:

“On the Jia Yi (1st and 2nd Celestial Stems) day, do not needle the head or utilize the method “Fa Meng” (light up vision) to treat the eyes and ears. On the Bing Ding (3rd and 4th Celestial Stems) day, do not use the method “Chen Ai” (raise dust) to needle the shoulder, throat and the point Lianquan (CV 23) . On the Wu Ji (5th and 6th Celestial Stems) day and on the day responding to Si Gui (“4 Precious” designating Chen, Wei, Xu and Chou, that is to say, the 5th, 8th, 11th and 2nd Terrestrial Branches) do not needle the abdominal area or utilize the method Ju Zhao (remove fingernail) to disperse water (organic liquid). knee. foot.

On the Gong Xin (7th and 8th Celestial Stems) day, do not needle the thigh and On the Ren Gui (9th and 10th Celestial Stems) day, do not needle the leg and Such are the Wu

Jin (5 prohibitions). ”

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains:

“1. The 10 Celestial Stems start on the Jia-Yi (1st and 2nd Celestial Stems) day and end on the Ren-Gui (9th and 10th Celestial Stems) day. Each has its correspondence: _ Jia-Yi (1st and 2nd Celestial Stems) respond to the head _ Ren-Gui (9th and 10th Celestial Stems), to the feet _ Bing-Ding (3rd and 4th Celestial Stems), to the upper part of the body _ Gong-Xin (7th and 8th Celestial Stems), to the lower part of the body

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In order to respond to the 4 Seasons (Heaven).

174.

2. Wu-Ji (5th and 6th Celestial Stems) respond to Earth. This is why it meets up with Si-Gui (“4 Precious” designating the 4 Terrestrial Branches, 5th, 8th, 11th and 2nd, that is to say, Chen, Wei, Xu and Chou). 3. Jia (1st Celestial Stem) designates Yang-Wood and Yi (2nd Celestial Stem), Yin-Wood. Yin and Yang spontaneously gather together and not under the action of the metabolism of the energy. 4. Fa Meng (Light Up Vision) and Chen Ai (Raise Dust) are two methods of “ventilating” the energy. 5. The 10 Celestial Stems create and transform the “5 Movements” of Earth. The union of these stems is spontaneous; this is why it is forbidden to “extract” the Qi (that is to say, to needle) on the days of the activity of these stems.” II - Ma Shi states: “The parts of the body responding to the “Celestial Stems” are: _ the head, on day Jia-Yi (1st and 2nd Celestial Stems) _ the shoulder, neck and throat, on day Bing-Ding (3rd and 4th Celestial Stems) _ the thigh and knee, on day Gong-Xin (7th and 8th Celestial Stems) _ the leg and foot, on day Ren-Gui (9th nd 10th Celestial Stems). Thus, it is forbidden to needle one these regions of the body on the corresponding day.”

III - N.V.N.: 1. Fa Meng is a needling technique of used in ENT. Therefore, for example, in hypoacusia and amblyopia, needling the point Tinggong (SI 19) must be done at the Wu hour (7th Terrestrial Branch, that is to say, “11-13h”). 2. Chen Ai is a needling technique used to treat Yang afflux at the level of the thorax with the following manifestations: cough, dyspnea, thoracic fullness, fear of dust and smoke... . In this case, Tianrong (SI 17) and Lianquan (CV 23) are two specific points used. (Fig. 1) 3. Gu Zhao is a technique of dispersion of “Water encroaching on Earth-Spleen” causing a stiffness of the limbs, lumbar region and knee joint with acute or chronic inflammation, dryness or with effusion of the synovial membranes, particularly tendinous synovia. It concerns a simple needling technique to remove liquid located in the cutaneous system. These techniques and point utilized are described in Chapter 75 of this classic (“Effects of Needling on the Source Energy and Perverse Energy”). 175.

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PARAGRAPH 3

Figure 1 The three points cited in Chapter 75 of thic classic.

Huangdi: “What is the meaning of “5

Exhaustions” (Wu Dua) ? ”

Qi Bo:

“Extreme weight loss (cachexia) applies to the 1st exhaustion. Extreme weakness after marked hemorrhage characterizes the 2nd exhaustion. Extreme weakness after marked sweating qualifies the 3rd exhaustion. Extreme weakness after marked diarrhea involves the 4th exhaustion. Extreme weakness after post-partum metrorrhagia characterizes the 5th exhaustion. In all these cases, the method fo dispersion is strictly advised against.”

EXPLANATIONS AND COMMENTARIES

176.

Zhang Shi: “In the cases of cachexia and escape of the energy and blood, even in the presence of perverse energy, dispersion is strictly prohibited.”

PARAGRAPH 4 Huangdi: “What is the significance of the “5

Contraries” (Wu Ni) ? ”

Qi Bo:

“1. The disease of heat, with calm (Jing) pulse and sweating with agitated ( D o n g ) , applies to 1st Contrary. 2. Diarrhea, with w i d e √ (Hong) a n d changing (Da) pulse, involves the 2nd Contrary. 3. “Zhua Bi” (chronic paresthesia), with articular inflammations, inflammatory rheumatism, feverish body and empty (Xu), pulse designates the 3rd Contrary. 4. The overflowing of the perverse energy toward the exterior, with dry and thinned body, fever, pale color and melena (sign of seriousness of the disease),

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characterizes the 4th Contrary. 5. The disease of Cold-Heat, in the chronic state with emaciation (weight loss) and hard pulse, indicates the 5th Contrary. Such are the “5 Contrary” (Wu Ni). ” EXPLANATIONS AND COMMENTARIES I - Ma Shi explains:

“1. The heat disease with calm pulse is an Yang affliction with Yin pulse. 2. The full and hurried pulse after sweating indicates the non-excretion of perverse energy via the sweat gland.

177.

3. With diarrhea, the pulse is generally deep and weak. In contrast, the wide√ and changing pulse heralds an excretion of Yin toward the bottom and a Yang fullness toward the top, that is to say, a separation of Yin and Yang, top and bottom. 4. Zhua Bi (chronic paresthesia) with “rupture-decay” of the muscular masses is due to the presence of perverse humidity which alters the “Xing” (form) and becomes transformed little by little into heat. The exhausted pulse indicates the total deterioration of the Spleen-Stomach system. “Weight loss, whitish color and melena” are the signs heralding the annihilation of the energy (of the exterior) and escaping of blood and organic liquid (of the interior). This phenomenon bears the name “Separation/Escaping” of blood and energy. 5. The dimunition of bodily form caused by cold and heat with strong and hard pulse indicates the fullness of perverse energy and emptiness of essential energy. In these 5 Contrary” syndromes, acupuncture is strictly forbidden.” II - N.V.N.: In relationship to the “5 Contraries” (Wu Ni), Zhang Jing Yue (1563-1640 A.D.) furnishes us with the following information: “1. The disease of heat with calm pulse is a Yang syndrome with Yin pulse. After sweating, the full (Shi) and hurried pulse indicates the exhaustion of the energy of the Yin root. 2. With diarrhea, instead of a calm pulse, the wide√ (Hong) and changing (Da) pulse denotes the presence of Yang in a victorious state. 3. In the Zhua Bi disease (chronic paresthesia), “rupture” of the muscular mass, hot body and exhausted (empty) pulse heralds the escaping of Yuan Qi (source energy). 4. Overflowing of perverse energy toward the exterior, dried out and thinned body, melenous stools with coagulated blood... results from the escaping of Jing (quintessence) and Qi (energy), causing the depletion of Yin with heat manifestations (fever). 5. In the Cold-Heat disease, thinned body and hard and full pulse denotes a serious attack on SpleenStomach with appearance of Organ-Root.

The 5 Contrary syndromes (Wu Jin) are all associated with “Emptiness of Yin” conforming to Chapter 8 of this classic (“Origin of the Mental”): “... The 5 organs receive the Jing (quintessence). One must never injure the Jing beacuse this lesion spontaneously causes Emptiness of Yin expressing as a deprivation of energy. The prognosis is fatal. As a result, those manipulating the needles must carefully study the state of the patient to determine the presence or absence of Jing, Shen, Hun, Po and Yi. If these 5 components are absent, treatment by acupuncture is advised against.”

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no. 178/179.

CHAPTER LXII Arterial Points (Dong Shu) (1)

Chapter 62 of the Lingshu raises the problem of the existence of “arterial points” (Dong Shu) at the level of the 3 channels: Hand Taiyin (Lu), Foot Yangming (St) and Foot Shaoyin (Ki). _ The arterial points of Cun Kou (radial pulse), Taiyuan (Lu 9), Jingqu (Lu 8) and Lieque (Lu 7) are propelled by the energy of the lung in relation to the unceasing movements of inspiration and expiration. _ The arterial point of the Foot Yangming (St), Renying (St 9), is propelled by Han Qi (free energy exempt from constraint) of the stomach. _ the arterial point of the Foot Shaoyin (Ki), Taixi (Ki 3), is propelled by the energy of the descending branch of the Chongmai. This chapter also addresses the obvious relevance of the Luo Vessels (Longitudinal Luo or Luo Bie) and Si Jie (4 points of passage, entry and exit) in the circulatory process of Ying Qi (nutritive energy). Ma Shi emphasizes: “Chapter 62 of the Lingshu gives dissertation on the unceasing pulsations of certain points located on the Hand Taiyin (Lu), Foot Yangming (St) and Foot Shaoyin (Ki), hence the title of this chapter.” This chapter consist of 4 paragraphs.

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1. Literally, “Dong” in the sense of “Dong Mai” which means “arterial vessels”, and “Shu” designates the energetic points of unceasing movements.

PARAGRAPH 1

180.

Huangdi: “Among the 12 Jingmai, only the Hand Taiyin (Lu), Foot Yangming (St) and Foot Shaoyin (Ki) are endowed with arterial points. Why?” Qi Bo:

“This underscores, even more, the importance of the relationship between the energy of the stomach and the pulse. The stomach is the “sea” of the 5 organs and 6 bowels. The pure energy reaches the lung. The energy of the lung starts via the Taiyin (Lu) and follows the respiratory rhythm. Each expiration responds to 2 pulsations, and each inspiration, also to 2 pulsations. Inspiration and expiration are uninterrupted. This is why the pulsations are unceasing.” Huangdi: “The energy passes via Cun it progresses rapidly. Where does where does is leak/escape/recede What are the routes of this clearly grasped their mechanism.

Kou (mouth of the inch: radial pulse); this energy come from? When it regresses slowly, fuit√? progression and this regression? I have still not Please inform me.”

Qi Bo:

“When the energy leaves the organ for the exterior, it is as rapid as an arrow shot from a bow, like a waterfall dropping into a river. At its arrival at the thenar eminence (Yuji- Lu 10) , the energy grows progressively weaker; the residual energy becomes dispersed in order to carry out an ascent. From here, the energetic potential gradually dies doww.”

EXPLANATIONS AND COMMENTARIES I - Ma Shi explains:

“Huangdi questions about the pulsatile (arterial) points belonging only to the Hand Taiyin (Lu), Foot Yangming (St) and Foot Shaoyin (Ki) such as: _ Taiyuan (Lu 9) _ Renying (St 9) _ Taixi (Ki 3) _ Chongyang (St 42)... . Concerning the points of the other vessels, the pulsation is weak and imperceptible, hence Huangdi’s question. • Qi Bo’s reply calls forth, in the first place, the channel of the lung because this channel, although starting at the lung organ, has its source at the stomach. Therefore, it is necessary to carefully study the stomach vessel to better understand the lung vessel. The stomach,“sea” of the 5 organs and 6 bowels, recieves the Cereal Water (Shui Gu: food) in order to transform it into energy. That contained in the Shangjiao (Upper Jiao- UJ) bears the name Xin Qi (metabolized

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energy or new energy) and that contained in the Zhongjiao (Middle Jiao- MJ) is named Ying Qi (nutritive energy). 181. Ying Qi is a pure energy (Sheng Qi). it is elaborated at the Zhongjiao (MJ). It descends to the Xiajiao (Lower Jiao- LJ), then asecnds to the Shangjiao (UJ). This energy contained in the stomach is only the Wei Qi (energy of the stomach) (2), also called Zu Qi (energy of the foot or energy of Foot Yangming- St). Therefore, Sheng Qi (pure energy coming from foods) follows the Xin Qi (metabolized energy or new energy) in order to circulate within the Jingmai, then, under the action of the Zhongjiao (MJ), it flows into the lung to be transported into the Taiyin (Lu). Then from there, it reaches: _ the Hand Yangming (LI) _ Foot Yangming (St) _ Foot Taiyin (Sp) _ Hand Shaoyin (He) _ Hand Taiyang (SI) _ Foot Taiyang (Bl) _ Foot Shaoyin (Ki) _ Hand Jueyin (XB) _ Hand Shaoyang (SJ) _ Foot Shaoyang (GB) _ Foot Jueyin (Li), finally returning to the Hand Taiyin (Lu).

a - This cyclic circulation follows the respiratory rhythm. Each inspiration responds to 2 pulsations, and each expiration also to 2 pulsations, to which one must add 1 more respiration responding to the movement of rest, that is, a total of 5 pulsations for each respiration. Inspiration and expiration, being in continual motion, the pulsations are unceasing. b - Cun Kou (mouth of the inch: radial pulse), site of reunion of the 12 Jingmai, belong to the Hand Taiyin (Lu) where the point Taiyuan (Lu 9) is found. The energy leaves the organ like an arrow flying from a bow. When it arrives at Cun Kou, it passes to the thenar eminence in order to pursue its trajectory. But once arriving at Yuji (Lu 10), the energy grows weaker. As a result, when it leaves the thenar eminence, it spreads thin to carry out an ascending movement (toward Shaochang- Lu 11). This is why, the other channels, once arriving at the thenar eminence, manifest by weak and small pulsations. 182.

c - The lung, site of outcome/result of the “100 vessels”, is the only organ endowed with uninterrupted movements. It cannot be compard to the other organs.”

II - N.V.N.: The original text of this paragraph is extremely difficult to interpret. Our translation is based of the explanations of Zhang Jing Yue (1563-1640 A.D.).

2. According to Ma Shi, one distinguishes 2 types of Ying (Rong) energy, that contained within the Jingmai called Wei Qi (“Wei” = stomach, “Qi” = energy) and that circulating within the Jingmai called “Ying (Rong) Qi (nutritive energy). Do not confuse the energy of the stomach, Wei Qi, with the defensive energy called Wei Qi.

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PARAGRAPH 2 Huangdi: “Where do the pulsations of the Foot Yangming (St) come from?” Qi Bo:

“The energy of the stomach flow out into the lung. A part of this energy, Han Qi (free energy exempt from constraint) , reaches the cephalic region via th laryngo-pharyngeal route, _ _ _ _ _ _ Renying

reaches the “7 orifices” (eyes, nose, ears, mouth) penetrates into the brain via the ocular system comes back out at the forehead passes to the point Re Zhu Ren (other for Shangguan- GB 3) reaches the point Jiache (St 6) to unite with Foot Yangming (St) and redescends with the Foot Yangming (St) to the point (St 9) .

The infiltration of these vessels of the energy of the stomach in this cephalic region transmits unceasing pulsations to Renying (St 9: carotid pulse) . Therefore, Yin and Yang, top (Renying: carotid pulse) and (Cun Kou: radial pulse) beat in unison. This is why:

bottom

_ in the Yang disease, the small pulse is contrary _ and in the Yin disease, the large pulse is contrary. string

In total, Yin and Yang are in together in movement and restlike a tense whose relaxing represents the disease.”

EXPLANATIONS AND COMMENTARIES I - Ma Shi explains:

“This paragraph concerns the pulsations of the energy of the Foot Yangming (St). Han Qi, elaborated at the Shangjiao (UJ), is totally Yang. It makes up part of the energy of the stomach. 183.

When the energy of the stomach arrives at the lung, Han Qi rises up toward the head via the path of the throat. First, it affects the “7 orifices”, and via the ocular path, it comes back out via the point Jingming (Bl 1), then successively passes the points: _ Zanshu (Bl 2) _ Quchai (Bl 4) _ Wuchu (Bl 5) _ Chengguang (Bl 6) _ Tongtian (Bl 7) _ and Luoque (Bl 8) to penetrate into the brain. From the brain, it emerges at the forehead, reaching the point Shangguan (GB 3), and descends to the point Jiache (St 6), where it unites with the Foot Yangming (St) which accompanies it to the point Renying (St 9). This particular vessel of the energy of the stomach ascends and descends in such a way that top and

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bottom, Yin and Yang beat in unison. In individuals affected by Yang diseases, the pulse must be wide and large because the small pulse is contrary (to the disease). As a result, in the case where the Yang disease is calm and the Yin disease is agitated like drawing a string on the/one’s side√, this represents disease. Such is the cause of the permanent beating of the pulse of the stomach from which one can determine the nature of the disease.”

II - N.V.N.: This paragraph involves the processes of the unceasing movements of the point Renying (St 9: carotid pulse) of the Foot Yangming. (Figure 1) Zhang Jing Yue specifies: “The energy of the stomach is the Yangming; its pulse is reflected at Renying (St 9: carotid pulse). That of the lung is the Taiyin; its pulse is reflected at Cun Kou (radial pulse). As a result, the energy of the stomach and that of the lung are mutually controlled; their pulsations are in harmony as if they were one”. In clinical practice, Cun Kou of the right wrist bears the name Qi Kou (“mouth of the energy”) and that of the left, the name Renying (“human reception”). Ma Shi’s explanation in Chapter 19 (“Energies of the 4 Seasons”), Paragraph 16, of this classic is the following: “Examination of the pulse is aimed at appreciating the state of worsening or improvement of the disease. Examination of Qi Kou is performed at the right wrist, and examination of Renying, at the left pulse. If Qi Kou is neither firm, nor full, nor slippery, but soft, it denoted the regression of the disease of endogenous etiology; if Renying reveals the same qualities, it indicates the disease of exogenous etiology in the process of disappearing. 184.

In the presence of these pulses, if the channels are still in a state of fullness, the disease evolves in 3 days toward cure. Qi Kou (right radial pulse) is intended to respond to diseases localizing at the 6 Yin channels (feet and hands) because it belongs to the energy coming from the organs (Yin). Similarly, Renying (left radial pulse), belonging to the energy coming from the bowels (Yang), is intended to respond to diseases localizing at the 6 Yang channels (feet and hands).”

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Figure 1: Circulation of Han Qi (free energy exempt from constraint) of the stomach and the Renying (carotid) pulse.

PARAGRAPH 3 151

185.

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Huangdi: “Where do the arterial pulsations of Foot Shaoyin (Ki) come from?” Qi Bo:

“Chongmai, “sea” of the 12 Jingmai, is a great vessel coming from the kidney. A branch passes to Qijie (other name for Qichong- St 30), descends the inner thigh, reaches the posterior part of the internal malleolus, arrives at the top of the foot via the path of the Luo of the Foot Shaoyin (Ki) (where Dachong- Ki 4 is located) to heat up the bones and muscles of the leg. It is therefore via the energy of Chongmai that the pulsations of the Foot Shaoyin (Ki) are unceasing.”

EXPLANATIONS AND COMMENTARIES I - Ma Shi specifies:

“This paragraph concerns the arterial point of the Foot Shaoyin (Ki), Taixi (Ki 3), located on the posterior tibial artery, behind the internal malleolus. The Chongmai, one of the “8 Curious Vessels” large vessel coming from the kidney, has a branch which passes to Qijie (Qichong- St 30), descends the inner surface of the thigh, follows the Foot Shaoyin (Ki) in order to descend the inner thigh of the leg and cross the points: _ Fuliu (Ki 7) _ Shaohai (Ki 6) _ Shuiquan (Ki 5) _ Dachong (Ki 4)... in order to arrive at Yongquan (Ki 1) located at the sole of the foot. Once having arrived atDachong (Ki 4), Luo point of the Foot Shaoyin (Ki), the Chongmai emits numerous little vessels toward the top of the foot where the point Chongyang (St 42), located on the pedal artery, is found in order to heat up the lower limb. (Figure 2) It is therefore via the Chongmai that the pulsations of the Foot Shaoyin (Ki) are unceasing.”

II - N.V.N.: Chapter 38 of this classic (“Contrary and Favorable. Fat and Thin”) also describes the descending branch of the Chongmai (3). We recall it here: Huangdi: “Only the Foot Shaoyin (Ki) is endowed with a vessel directed toward the bottom. Is this that?” 186. Qi Bo: “This is not that. There is the Chongmai named “Sea” of the 5 Organs and 6 Bowels. The 5 organs and 6 bowels are maintained in blood and energy by the Chongmai. This blood and energy is directed toward the top and emerges via the throat where it flows down into the Yang channels. At the bottom of the abdomen, it has a vessel which projects into Qijie (other name for Qichong- St 30) and from there it runs alongside the inner thigh and penetrates into the popliteal crease and edges its way toward the inner surface of the leg to permeate the 3 Yin channels to behind the internal malleolus where the great Luo of the kidney is found, bearing the name 3. See Lingshu, Volume II, page 253, N.V.N. Edition, page 235, J.T.S. Edition.

Dachong (Ki 4). At this level, numerous branches penetrate toward the top of the foot and into the space of the great toe where they permeate and heat up the muscles and tendons.

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Figure 2: Descending branch of the Chongmai and its branches. 187.

In the event of stagnation of these little vessels, the artery (pedal) stops beating, and the absence of pulse at the top of the foot indicates Jue Ni (afflux), origin of cold (of the feet).” Huangdi: “On what basis to you say that?” Qi Bo: “It is based on patient questioning and palpation of the pulse (of the pedal artery). In the absence of stasis, the artery continues to beat. Therefore, we know how to understand the favorable and unfavorable reason.” Huangdi: “The Dao (of acupuncture) transmitted by the sages is deep! It is more luminous than the sun and moon, more subtle than Hao and Li (4). Without you, no one would be able to explain this Dao.” 4. Small ancient coins or, more exactly, small units of measure: Hao = centimeter; Li = miilimeter.

Ma Shi furnishes a similar explanation in this regard: “This paragraph concerns the descending trajectory of the Chongmai. The Chongmai is the “sea” of the 5 organs and 6 bowels because it maintains them in blood and energy. Its descending trajectory starts at Qijie (Qichong- St 30), runs alongside the inner thigh to the popliteal crease and flows alongside the inner leg to the point Dachong (Ki 4), located behind the iinternal malleolus

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where numerous branches depart: _ the ascending branches start at Qijie and are directed toward the leg and permeate the 3 Yin channels (liver, spleen and kidney), _ and the branches which reach the top of the foot and pass to the point Yingquan (Ki 1) on the one hand, and the space of the great toe on the other hand, permeate the Luo to heat up the muscles and tendons. (Figure 2) In the event of stasis at the level of these branches, absence of beating of the artery (pedal) indciates a contrary afflux (Jue Ni), responsible for cold feet. But what criterion explains this? One basis one’s judgment on information from the patient before examining the pulse. If the artery (pedal) ceases beating, it is an unfavorable sign; the opposite is favorable. The absence or presence of energetic afflux at the level of the foot is therefore easy to diagnose.”

PARAGRAPH 4 Huangdi: “ Ying (nutritive energy) and Wei (defensive energy) circulate everywhere within the body, above and below, like a circle without end. During attack by perverse energy or great cold, the limbs are fatigued and lax, Yin and Yang are perturbed, the points of reunion of blood and energy are in disequilibrium... . What path aids the Qi to circulate beforehand?”comme aupraravent 188.

Qi Bo:

“The 4 limbs are the sites of gathering of the Yin channels and Yang channels. The are also the sites where the Luo vessels belonging to the Jingmai depart from. The Si Jie (4 sites of passage, entry and exit) are quicker/ shortened √ r a c c o u r c i sites of reunion of Qi (Ying and Wei). This is why, despite the obstruction of these Luo vessels by perverse energy, the correlation of Yin and Yang of the channels continues to be assured by the routes of the Si Jie. When the 4 limbs are free of perverse energy, Y i n g and Wei resume their normal pathway (path of the Luo) in order to circulate like a circle without end.” Huangdi: Correct! This is clearly the meaning of the “Necklace of Jade without beginning or end” whose cycles are constantly renewed, cannot be enumerated. This clearly explains the problem I wanted to delve deeply into.” EXPLANATIONS AND COMMENTARIES I - Ma Shi explains:

“This paragraph speaks on the circulation of Ying and Wei, like a circle without end, not able to be stopped by any perverse energy. Huangdi would like to be informed: _ about Ying Qi which follows the Tong Qi (a priori energy) in order to circulate within the channels, beginning by the Hand Taiyin (Lu) and ending by the Foot Jueyin (Li), _ and about Wei Qi circulating within the interchannel spaces and within the pilo-cutaneous system, beginning by the zones associated with the Foot Taiyang (Bl) and ending by the Foot Taiyin (Sp).

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• Yin and Yang channels communicate like a circle without beginning or end. Faced with the case of an individual, suddenly in the presence of perverse energy or great cold, presenting fatiguability and laxity of the limbs, _ how can these channels avoid obstruction? _ by what pathway can Ying circulate as before, that is to say, beginning by the Hand Taiyin (Lu) and ending by the Foot Jueyin (Li)? _ and by what pathway can Wei circulate like before, that is to say, beginning by the Foot Taiyang (Bl) and ending by the Foot Taiyin (Sp)? The problem is quite delicate.

Our reply is that of Qi Bo’s. In effect, _ the 4 limbs are the sites of reunion of beginning and ending of the Yin and Yang channels (5). They are also the sites of connection of the Luomai and Jingmai. _ Si Jie are the 4 points of opening by which Ying Qi circulating within the channels communicate with Wei Qi circulating outside the channels within the flesh and skin. 189. Therefore, in the case of obstruction of the Luo vessels, there are always other paths of aeration which are free that allow the Ying Qi to circulate following a circle without end. This is why neither perverse energy nor great cold can stop it.”

II - N.V.N.: This paragraph’s theme is the role of the Luo vessels (Longitudinal Luo or Luo Bie: Distinct Luo) and “Si Jie” (4 points of passage, entry and exit) in the circulatory process of Ying energy within the channels. Recall that: _ the Luo points are the principal mechanisms of aeration of the Jingmai _ the Qijie points, four in number, called “Si Jie” are the auxillary mechanisms of aeration of the Jingmai (5).

5. See Chapter 52 of the Lingshu (“Defensive Energy”), page 47, J.T..S. Edition. no 190/191.

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CHAPTER

LXIII

Dissertation on the Five Sapors (Wu Wei Lu)

This Chapter 63 of the Lingshu speaks on the distribution of the “5 Sapors” at the level of the organs. The excessive supply of sapor can cause diseases. The title, “Dissertation on the Five Sapors” (Wu Wei Lu), is thus explained. This chapter consists of 5 paragraphs.

PARAGRAPH 1 Huangdi questions Shao Yu: “The “Five Sapors”, elaborated at the level of the stomach, are all directed toward their site of distribution and can cause disease. Therefore, _ the sour sapor is directed toward the muscles and its urinary retention. _ the salty sapor is directed toward the blood part and thirst. _ the spicy sapor is directed toward the energetic part provoke the sensation of emptiness of the heart. _ the bitter sapor is directed toward the bones and its nausea and vomiting. _ the sweet sapor is directed toward the flesh (dermis) provoke melacholy.

excess can provoke its excess can provoke and its excess can excess can provoke and its excess can

I know this, but I unaware of their origin. Can you tell me the cause.” Shao

Yu replies: 192. “During penetration of sour sapor into the stomach, its energy, of immersing and astringent quality, is directed toward the two Jiao (Zhongjiao- Middle Jiao/MJ and Shangjiao- Upper Jiao/UJ) and can no longer carry out movements of entry and exit, that is to say, it remains in the stomach. If the interior of the stomach is temperate, this energy (sapor) reaches the descending route and inserts into the bladder whose wall is thin and supple. In contact with the sour sapor, this wall retracts and causes blockage of the liquid circulation, hence urinary retention. Yin Qi designates the genito-urinary system, site of gathering of the energy of the muscles. This is why, when the sour sapor reaches the liver, it extends

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toward Tong Jin (Union of Muscles).

EXPLANATIONS AND COMMENTARIES Ma Shi clarifies:

“The sour sapor is an energy of a “descending, gathering and conserving” nature. Arriving at the Zhongjiao (Middle Jiao: fundus) of the stomach, it becomes directed toward the 2 Jiao: Zhongjiao (MJ) and Shangjiao (UJ). The moderate and well-balanced heat (Wen) of the interior of the stomach prompts it to reach the bottom and insert into the bladder. The vesicular covering membrane, thin and supple, becomes retracted upon receiving the sour sapor. This retraction blocks the liquid route, hence urinary retention. The liver governs the muscles. Its sapor is sour. This is why, in the interior, urinary retention is its illness, and at the exterior, it extends toward Tong Jin (reunion of accumulated muscles in the pubic region) at the level of Yin Qi (energy of the genital organs). In this regard, in Chapter 23 of the Suwen (“Discourse on the Five Energies”), it is advised: “Sour disperses the muscles. In diseases of the muscles, do not give overly sour foods.”

PARAGRAPH 2 Huangdi: “ T h e salty sapor reaches the blood part. Its excess can cause thirst. Why?” Shao

Yu: 193. “When the salty sapor penetrates into the stomach, its energy reaches the Zhongjiao (MJ) which directs it into the blood vessels. It then produces a fusion of blood and salty sapor, responsible for blood stagnation bringing with it an afflux of stomach water in order to augment the hygrometric degree. Then, when the water of the interior of the stomach is exhausted, the pharyngeal path and base of the tongue dry out, giving a sensation of thirst.

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These blood vessels are circulatory routes dependent on the Zhongjiao (MJ). This is why, once within the stomach, the salty sapor passes spontaneously into the blood.”

EXPLANATIONS AND COMMENTARIES I - Ma Shi clarifies:

“This paragraph concerns the overly salty food causing thirst. Once within the stomach, the salty sapor must necessarily flow down into the Zhongjiao (MJ) before passing into the blood because this is the site of departure of all blood and energetic vessels of the organism. Blood stagnation due to fusion of blood and salty sapor automatically triggers a call to the lqiuid substance contained within the stomach, hence exhaustion of gastric liquid, responsible for dryness of the throat (pharynx) and tongue with sensation of thirst.”

II - N.V.N.: The explanaton of the process of formation of blood stagnation given by Ren Yu Yin is very close to that furnished by Ma Shi. According to him, “Blood is a thick substance of red color conditioned by the Zhongjiao (MJ) which executes the order of the Shen lodged within the heart. The salty sapor is an energy belonging to Water-Cold. As a result, the fusion of blood and salty sapor causes the phenomena of stagnation and dryness/accumulation, hence the necessary presence of liquid substance contained within the stomach to humidify them. Upon exhaustion of this liquid substance, the laryngo-pharyngeal route and base of the tongue dry out provoking the sensation of thirst. Blood vessels are pathways belonging to the Zhongjiao (MJ). When the energy of the salty sapor arrives at the Zhongjiao (MJ), it spontaneously passes into the blood.”

PARAGRAPH 3

194.

Huangdi: “The spicy sapor reaches the energetic part. Its excess can provoke agitation of the heart (sensation of emptiness of the heart). Why?” Shao

Yu: “When the spicy sapor arrives in the stomach, its energy ascends toward the Shangjiao (UJ) whose function is to receive the dietary Jing and distribute it into the Yang (external) parts of the body. Therefore, when sapor energy of ginger and garlic rises up toward the Shangjiao (UJ), it stimulates without stopping the Ying (nutritive energy) and Wei (defensive energy). If it remains in the region “under the heart” (epigastric) for a longtime, it causes “agitation” of the heart (emptiness of the heart). The spicy sapor circulates with the Qi ( 1 ) . Together, they can reach the exterior by sweating.”

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EXPLANATIONS AND COMMENTARIES I - Ma Shi clarifies:

“This paragraph concerns overly spicy food with the ability to provoke a sensation of “emptiness of the heart” (agitation of the heart). When the spicy sapor arrives in the stomach, its energy must necessarily reach the Shangjiao (UJ) because it is the site of reception of Qi. As a result, the energy of the spicy sapor, once it has arived at the Shangjiao (UJ), cannot interfere with the Qi. Wei (defensive) energy, elaborated from the Xiajiao (LJ), circulates within the intercellular spaces. At this level, the Wei receives the energy of the spicy sapor. If the spicy sapor of ginger and garlic stagnates for a longtime within the region “under the heart” (gastric), it can disturb this region and rise up toward the Shangjiao (UJ) to trigger a sensation of “emptiness of the heart”. Moreover, during their meeting, the spicy sapor and the energy of the heart fuse and circulate together. The arrival of the spicy sapor expresses as sweating, indicator of the escaping of the energy Therefore, how can the heart not be in emptiness? Chapter 23 of the Suwen (“Disocurse on the Five Energies”) advises: 195. “Spicy disperses the Qi. In diseases of Qi, do not give overly spicy foods”.”

II - N.V.N.: This paragraph accentuates the functions of the Shangjiao (UJ) and Xiajiao (LJ). Their misappreciation renders the practice of acupuncture uncertain.

1. In medicine, Qi designates Ying and Wei and not “breath” (movement of air that one produces upon expiring forcefully) as has been claimed by some European acupuncturists.

PARAGRAPH 4 Huangdi: “The bitter sapor is directed toward the bones. Its excess causes nausea and vomiting. Why?” Shao

Yu: “The bitter sapor , in penetrating into the stomach, perturbs the energy of Wu Gu (5 Cereals), foods that can no longer defeat it. So, it descends into Xia Wan (lower portion of the stomach) where it: _ obstructs the circulatory paths of the Sanjiao (SJ): Shangjiao (UJ), Zhongjiao (MJ) and Xiajiao (LJ). _ disturbs the metabolic functions of the stomach _ and causes the dysharmony of the Qi (energy), hence nausea and vomiting. • The teeth, making up part of the osseous system, are called “terminal sites of the bones”.

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The spicy sapor , once in the stomach, is directed first toward the bones, that is to say, the teeth. Therefore, nausea and vomiting are the indicators of the penetration of bitter sapor into the bones.”

EXPLANATIONS AND COMMENTARIES Ma Shi clarifies:

“This paragraph involves the nausea and vomiting due to overly bitter foods. Once in the stomach, the bitter sapor cannot be defeated by the other energies (already contained within the stomach); it descends into Xia Wan (lower portion of the stomach where the point xxxxx - CV 10 is found), and the energies located at the Zhongjiao (MJ- xxxx- CV 12) and Shangjiao (UJ- xxxxx- CV 13) become obstructed, hence the phenomena of dysharmony of the energy of the stomach, responsible for nausea and vomiting. 196.

The teeth are the terminal parts of the bony system. When the bitter sapor reaches the bones, it also arrives at the teeth. As a result, post-prandial vomiting is the indicator of an attack of the bones by excessive bitter sapor.” Chapter 23 of the Suwen advises: “Bitter disperses the bones. In diseases of the bones, do not give overly bitter foods.”

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Figure 1: Overly bitter sapor within Xia Wan.

197.

PARAGRAPH 5 Huangdi: “The sweet sapor is directed toward the flesh (dermis). Its excess causes malancholy. Why?” Shao

Yu: “The sweet sapor arrives at the stomach. Its energy is slow and weak; it cannot ascend to the Shangjiao (UJ) and must remain with the other dietary energies within the stomach, hence stomach distention, responsible for “awakening” and “agitation” of parasites. This parasitosis is the cause of melancholy in man. The sweet sapor is directed toward the exterior. This is why its energy reaches the flesh (dermis).” EXPLANATIONS AND COMMENTARIES I - Ma Shi clarifies:

“This paragraph involves overly sweet foods with the ability to cause melancholy. The sweet sapor of supple quality rsponds to Earth. This is why its energy is weak and cannot reach the Shangjiao (UJ: cardia). Along with the other dietary energies, it stagnates within the Zhongjiao (MJ: fundus). As a result, the stomach becomes weak and distended. The sweet sapor attracts parasites. This is why the text speaks of “reawakening/agitation” of parasites, the cause of melancholy. Moreover, “the sweet sapor is directed toward the flesh” because the sweet sapor responds to Earth and Spleen-Earth governs the flesh (dermis). As the flesh is at the external part of the body, the energy of the sweet sapor, once within the stomach, consequently reaches this region in such a way that the interior (Li) and exterior (Biao) communicate. This is why the excess of sweet sapor causes melancholy.” II - N.V.N.: 1 - Zhang Jing Yue (1563-1640 A.D.) gives us the following information: “The nature of the sweet sapor is supple and fluid. Therefore, its energy is weak and modest and cannot ascend to the Sangjiao (UJ).

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This is why too sweet sapors come to a standstill within the stomach with the other dietary energies. In the chronic state, they unite with humidity to become transformed into lumbricoides whose movements influence the energy of the heart, hence “torments” of the heart (melancholy). In Chapter 23 of the Suwen, it is advised: “Sweet disperses the flesh. In diseases of the flesh, do not give overly sweet foods.” 2 - Ren Gu Yin issues the following remarks: “The sweet sapor is associated with the culture of ricefields. It responds to the energy of the Kun Palace ( ) corresponding to Earth whose property is “suppleness” and “humidity”. This is why the energy of the sweet sapor is weak and imperceptible. 198.

_ “Taiyin-Humidity-Earth” govern Qi and render it supple and humid. The “soft” quality belongs to Earth and the “wet” quality, to humidity. Lumbricoides are parasites responding to Yin. _ “Yangming-Dryness-Heat” is the natural energy of the stomach. If the stomach is weak and distended, the movements of lumbricoides allow the heart to be plagued by torments”. In conclusion, Chinese “dietetics” rely on very simple and clear principles. Its fundamental bases are developed in Chapter 23 of the Suwen (“Discourse on the Five Energies”) and Chapters 54 (“Celestial Age”), 63 (“Dissertation on the Five Sapors”) and 64 (“Yin and Yang and the 25 Morphotypes”) of the Lingshu. Unfortunately, the majority of works published on this subject in the West to this day do not conform to the spirit of Huangdi due to an imperfect and partial knowledge of Classical Chinese Medicine, causing confusion and lack of understanding. Also, Ma Shi has said: “In order to conquer lack of understanding, the best way is to endeavour to understand.”

199.

CHAPTER

LXIV

Yin and Yang and the 25 Morphotypes (Yin Yang Er Shi Wu Ren)

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Chapter 64 of the Lingshu speaks on the 25 Morphotypes according to Yin-Yang and the 5 Movements. Each morphotype is studied as a function of: _ _ _ _ _

the musical note (Jiao, Zhu, Gong, Shang, Yu) the coloration of the skin (white, yellow, black...) the bodily form (square face, rounded face...) behavior (sincere attitude, loyal...) and the 4 Seasons (spring, summer...).

The significance of this chapter resides in the study of the 3 Yin and 3 Yang channels (top/bottom, left/right) in light of determining the emptiness and fullness of blood and energy of each of the 25 Morphotypes. The therapeutic rules and princple of choice of points used in these cases are also addressed. Chapter 64, centered on the study of the 25 Morphotypes as a function of Yin and Yang and the 5 Movements, is therefore entitled: “Yin and Yang and the 25 Morphotypes (Yin Yang Er Shi Wu Ren)”. This chapter consists of 15 paragraphs.

PARAGRAPH 1 Huangdi: “I have heard something about 2 types of man responding to Yin and Yang. How do you distinguish them?” According to Ba Gao, within the space “Heaven-Earth” and within the “6 Regions” (4 cardinal points + anterior and posterior), the classification of beings and things do not leave the scope of the “5 Movements”. 200.

Each movement decays into “5 Different Impulses”. In this manner, there exist 5 X 5 = 25 types of man, besides the Yin type and Yang type, whose morphology is grouped into 5 different prototypes of normal type. I know all this; I would like simply to be informed of: _ these 25 types of man _ the formation of their energy and blood _ and the knowledge of the external structure in order to judge their interior. How do you distinguish them?” Qi Bo:

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“Your question is most pertinent! It concerns here knowledge carefully perserved by our Masters that Ba Gao was not yet able to elucidate.” Huangdi, leaving his place with deference, says: “I have heard this said. The experiences that have not been transmitted are a heavy loss. But experiences developed in a disorderly fashion are severely disapproved of. I wish to gather all the knowledge of our Masters and enclose them preciously in the Box of Gold.” Qi Bo:

“It is first necessary to determine the 5 prototypes of man responding to “Wood, Fire, Earth, Metal, Water” and then distinguish the 5 Colors in order to differentiate these 5 types of man which form in all 5 X 5 = 25 Morphotypes.” Huangdi: “Please teach me all of them.” Qi Bo:

“Therefore listen! I am going to explain them to you slowly and progressively.”

EXPLANATIONS AND COMMENTARIES I - Ma Shi explains:

“In this paragraph, Huangdi relates that Ba Gao had explained to him human morphology as a function of the 5 Movements. In the space “Heaven-Earth”, Tai Yi (“First Principle”: to pass from one extreme to the other) is divided into Yin and Yang, and Yin and Yang is divided in turn into “5 Movements” (Wu Xing). Therefore, within each movement exists 1 Yin and 1 Yang, and within Yin and within Yang exist the First Principle (Tai Yi). This is why Heaven, Earth and Man are necessarily found within the sphere of activity of the 5 Movements, and the organism must faithfully reflect this law. 201.

Each of these 5 Movements are regrouped into 5 other movements. Therefore, for example, Wood is the principle movement, but this movement is divided into “Top/Bottom” movement and “Left/Right” movement, making 1+2+2 = 5. Because the 5 Movements each consist of 5 other movements, human morphology responding to the 5 Movements is classified into 25 distinct types of man. As for men responding to the Yin channels and Yang channels, they do not enter into the context of the 5 Movements. Men responding to the 5 Movements each have a different morphologic type, energetic formation and blood. Therefore, “to base one’s judgment on the external aspect in order to judge the interior” is a notion that Ba Gao himself has not yet been able to elucidate.”

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II - N.V.N.: As for typology linked to the Jingmai (principal channels), Chapter 72 of the classic (“Celestial Relationships”) is devoted to it.

PARAGRAPH 2 Qi Bo:

“First, determine the 5 Protoypes responding to “Wood, Fire, Earth, Metal, Water”, then clearly differentiate the 5 Colors responding to the 5 Movements in order to establish the 25 types of man. The individual of “Wood” prototype, compared to the note Shang Jiao (upper J i a o ) , behaves like man of the East. • He is greenish in color and has a long face. The head is small. The shoulders are large. The back is straight. The body is small. The feet and hands are agile. He is talented and hard-working. He is preoccupied with and given entirely to his work. • He likes spring and summer and poorly tolerates autumn and winter. This type of man responding to the note Shang Jiao (upper Jiao) belongs to the Foot Jueyin (Li). His attitude is level-headed and presumption. 202. • The “ W o o d ” prototype is grouped into 4 morphotypes: top, bottom, left and right.

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1. The Wood morphotype modelled on the note Tai Jiao (major Jiao) is compared to the type responding to the Foot Shaoyang (GB) of the left and to the type responding to the upper part of the Foot Shaoyang (GB). Its attitude is affabilty and accomodation (with a tendency to submission). 2. The W o o d morphotype modelled on the note Xie Jiao (Jiao of the right) is compared to the type responding to the Foot Shaoyang of the right and to the type responding to the lower part of the Foot Shaoyang (GB). Its attitude is conformist. 3. The W o o d morphotype modelled on the note Di Jiao (upper left Jiao) is compared to the type responding to the Foot Shaoyang (GB) of the right and to the type responding to the upper part of the Foot Shaoyang (GB). Its attitude is toward progress (better, more advanced state). 4. The W o o d morphotype modelled on the note Fan Jiao (half Jiao) is compared to the typer responding to the Foot Shaoyang (GB) of the left and to the type rsponding to the lower part of the Foot Shaoyang (GB). Its attitude is honest and loyal.”

EXPLANATIONS AND COMMENTARIES I - Ma Shi explains:

“This paragraph speaks on the Wood prototype of man compared to the note Jiao and responding to the Foot Jueyin (Li). Wood corresponds to the East, to the note Jiao and to the color green. This is why the Wood type is compared to the note Shang Jiao (Upper Jiao) and man of the East (1). Greenish-gray is the color of Wood. “Small head” evokes the image of the branch of a tree. “Long face” evokes the image of the elongated shape of its vegetable. “Shoulders and back are large” evokes the image of the bushy appearance of its branches and leaves. “Straight body” evokes the mage of a tree trunk. 203. “Small feet and hands” evokes the appearance of branches and roots which are finer.

These comparisons therefore are based on the representation of Wood. “He is talented” like Wood, material of common objects. “He is not so rubust” like Wood with its fragile branches and easily stirred by wind. “He is preoccupied with and entirely given to his work” like Wood permanently active. “He like spring and summer” like Wood is lush during these two seasons. “He poorly tolerates autumn and winter” like Wood which loses its foliage and dries out during these two periods. These similarities then are based on the reactive phenomena of the 4 Seasons. This is why, in autumn and winter, in the event of attack of perverse energy, the disease belongs to the Foot Jueyin (LI). The signs of attack are basically nonchalance and fatigue (asthenia) belonging to the liver organ. The Foot Shaoyang (GB) and Foot Jueyin (Li) constitute the “Yin-Yang, Interior-Exterior” system of relationship.

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Shang Jiao (Upper Jiao) is the principal note responding the Liver-Wood (Foot Jueyin). Tai Jiao (major Jiao), Xie Jiao (Jiao of the left), Di Jiao (left upper Jiao) and Fan Jiao (halfJiao) are secondary notes associated with the mutation of Yin-Yang (responding to the liver and gallbladder). 204...

Foot Shaoyang (GB) of the left side and Foot Shaoyang (GB) of the right side, and their upper and lower parts, are the sites of gathering of the Jingmai (energy) and Xuemai (blood). Each responds to one tone (musical) which is proper to it: Tai Jiao, Xie Jiao, Di Jiao and Fan Jiao.”

1. Ancient China was divided into 5 regions: East, West, North, South and Center.

II - N.V.N.: 1 - The Wu Yin (5 basic notes of Oriental music) are utilized in medicine within the relationship between Heaven, Earth and Man. The Wu Yin are: Jiao, Zhi, Gong, Shang and Yu. Each fundamental note becomes divided into into Tai Jiao, Xie Jiao, Di Jiao and Fan Jiao. Generally, the Wu Yin (5 basic notes) represent the Wu Xing (5 Movements). In this way: _ Jiao responds to Wood _ Zhi, to Fire 205. _ Gong, to Earth _ Shang, to Metal _ Yu, to Water.

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Figure 1: The five basic notes of oriental music (Wu Yin) of Huangdi’s era. 204....

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Figure 2: “Wood” protoype compared the note Shang Jiao and to the Foot Jueyin (Li)

2 - This paragraph speaks on man of “Wood” prototype compared to the note Shang Jiao (upper Jiao) responding to the Foot Jueyin (Li) (Figure 2). • The “Wood” prototype is divided yet again into 4 morphotypes: top, bottom, left, right, belonging to the Foot Shaoyang (GB) because it is in “Yin-Yang, Interior-Exterior” relationship with Foot Jueyin (Li). 206.

a - The Tai Jiao (Upper Jiao) morphotype, compared to the left Foot Shaoyang (GB), is similar to the type responding to the upper part of the Foot Shaoyang (GB) because this part is the site of physiologic manifestations of the Foot Shaoyang (GB). Its attitude is accomodation and submission. b - The Xie Jiao (Jiao of the left) morphotype, compared to the Foot Shaoyang (GB) of the right, is similar to the type responding to the lower part of the Foot Shaoyang (GB) because this part is the site of manifestation of the physiologic natures of the Foot Shaoyang (GB). Its attitude is conformism.

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Figure 3: The four tones of Shang Jiao and their physiologic characterisitics.

c - The Di Jiao (left upper Jiao) morphotype compared to the Foot Shaoyang (GB) of the right is similar to the type responding to the upper part of the Foot Shaoyang (GB) because this part is the site where the physiologic characteristics of the Foot Shaoyang (GB) manifest. Its attitude is achievement toward progress. d - The Fan Jiao (half Jiao) morphotype compared to the Foot Shaoyang (GB) of the left is similar to the type responding to the lower part of the Foot Shaoyang (GB) because this part is the site of manifestation of the physiologic characteristics of the Foot Shaoyang (GB). Its attitude is honesty and loyalty (Figure 3).

PARAGRAPH 3 “The individual of the “Fire” prototype compared to the note Shang Zhi (upper Zhi) behaves like man of the South. • He is reddish in color with thin and pointed face. The body and back muscles are large. The hips and abdomen are well developed. The feet and hands are relatively small. The gait is well placed. The mind is quick and clear-sighted. He walks with body balanced. He has a generosity of spirit and disregards wealth and power. He loses confidence and appears preoccupied. He knows “human affairs” perfectly. He likes elegance and beauty. With a rapid and hurried heart, he does not profit from “Celestial Age” and dies suddenly. He likes spring and summer and poorly tolerates autumn and winter, periods during which he is easily attacked by perverse energy. Hand

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The “ F i r e ” type compared to the note Shang Zhi (upper Zhi) belongs to the Shaoyin (He). His attitude is sincerity and loyalty. 207.

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• The “Fire” prototype is divided into 4 morphotypes: top, bottom, left, right. 1 - The “ F i r e ” morphotype modelled on the note Zhi Zhi (substantial Zhi) is compared to the type responding to the Hand Taiyang (SI) of the left and to the type responding to the upper part of the Hand Taiyang (SI). His attitude is superficiality. 2 - The “ F i r e ” morphotype modelled on the note Shao Zhi (minor Zhi) is compared to the type responding to the Hand Taiyang (SI) of the right and to the type responding to the lower part of the Hand Taiyang (SI). His attitude is optimism and joy. 3 - The “ F i r e ” morphotype modelled on the note Yuo Zhi (Zhi of the right) is compared to the type responding to the Hand Taiyang (SI) of the right and to the type responding to the upper part of the Hand Taiyang (SI). His attitude is ambition. (He does not yield to the steps of others and poorly tolerates being behind others). 4 - The “ F i r e ” morphotype modelled on the note Zhi Fan (half Zhi) is compared to the type responding to the Hand Taiyang (SI) of the left and to the type responding to the lower part of the Hand Taiyang (SI). His attitude is self-conceit.”

EXPLANATIONS AND COMMENTARIES I - Ma Shi explains:

“This paragraph speaks on the “Fire” type of man divided into 4 archetypes: top, bottom, left and right. 1 - The “Fire” type corresponds to the South, to the note Zhi and the the color red. This is why the “Fire” type is compard to the note Shang Zhi (upper Zhi) and to man of the South. a - Red is the color of Fire. “Large body” evokes the image of the power of fire. “Thin and pointed face and small head” evokes the image of the slender and small appearance of the advancing wave of fire√. “Dorso-scapular region, plevic bone and abdominal muscles are well developed” evoking the image of the shape of fire whose dimension becomes progressively reduced toward the top. “The feet and hands are small” evokes the advance of the spreading of fire toward the 4 sides.” 208. “The gait is well placed” evokes the image of the formation of fire starting always via the bottom, then reaching the top. “The mind is quick” evokes the image of fire constantly in motion. b - “He possesses a generosity of spirit and disregards wealth and power” evokes the image of the spontaneous nature of fire. “He loses confidence and appears preoccupied”; he knows ‘human problems’ perfectly” evokes the image of the illuminated nature of fire that lights up all sides “Rapid heart” evokes the image of the smooth and bustling of fire. “Life is short and death sudden” evokes the image of the power of fire which is not eternal.

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c - “He likes spring and summer” because fire is powerful during these two seasons. “He poorly tolerates autumn and winter” because fire is weak during this period. Such are the basic characteristics of fire. Hand Shaoyin (He) responds to Fire. Blood and energy circulate abundantly because of their association with Fire.

2 - The 2nd part of this paragraph is focused on the Hand Taiyang (SI) because heart and small intestine constitute the “Yin-Yang, Internal-External” system of relationship. a - “Zhi Zhi” (Zhi substantial) is the 1st tonality of the basic note Zhi responding to the Hand Taiyang (SI) of the left and the upper part of the Hand Taiyang (SI, left and right: bilateral). b - “Shao Zhi” (Zhi minor) is the 2nd tonality of the basic note Zhi responding to the Hand Taiyang (SI) of the right and the lower part of the Hand Taiyang (SI, left and right). c - “Yuo Zhi” (Zhi of the right) is the 3rd tonality of the basic note Zhi responding to the Hand Taiyang (SI) of the right and the upper part of the Hand Taiyang (SI, left and right). d - “Zhi Fan” (half Zhi) is the 4th tonality of the basic note Zhi responding to the Hand Taiyang (SI) of the left and the lower part of the Hand Taiyang (SI, left and right).”

III - N.V.N.: In this paragraph, man of the “Fire” prototype is placed in similarity with the note Shang Zhi (upper Zhi) responding to the Hand Shaoyin (He) (Figure 4). The “Fire” prototype is distinguished yet again into 4 morphotypes: top, bottom, left, right responding to the Hand Taiyang (SI) because it has a “Yin-Yang, Interior-Exterior” relationship with Hand Shaoyin (He).” 209.

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Figure 4: The “Fire”prototype compared to the note Shang Zhi responding to the Hand Shaoyin (He). 1. The Zhi Zhi (substantial Zhi) morphotype compared to the Hand Taiyang (SI) of the left is similar to the upper part of the Hand Taiyang (SI) because this part is the site of manifestation of the physiologic characteristics of the Hand Taiyang (SI). Its attitude is superficiality. 2. The Shao Zhi (Zhi minor) morphotype compared to the Hand taiyang (SI) of the right is similar to the lower part of the Hand Taiyang (SI) because this part is the site of manifestation of the physiologic characterisitics of the Hand Taiyang (SI). Its attitude is optimism and rejoicing. 3. The Yuo Zhi (Zhi of the right) morphotype compared to the Hand Taiyang (SI) of the right is similar to the upper part of the Hand Taiyang (SI) because this part is the site of manifestation of the physiologic characteristics of the Hand Taiyang (SI). Its attitude is not to be behind others. 210. 4. The Zhi Fan (half Zhi) morphotype compared to the Hand Taiyang (SI) of the left is similar to the lower part of the Hand Taiyang (SI) because this part is the site of manifestation of the physiologic characteristics of the Hand Taiyang (SI). Its attitude is arrogance (Figure 5).

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Figure 5: The four tones of Shang Zhi and their physiologic characteristics.

PARAGRAPH 4 Shang

211.

“The individual of “Earth” prototype, compared to the note Gong (upper Gong), behaves like man of the Center. • He is yellow in color and has a round face. The head is large; the shoulders and back are sturdy. The abdomen is large. The thighs and legs are beautiful and the body well-proportioned. The gait is confident and the stride not very reduced. He has a peaceful heart and takes interest in others. He does not like power and only looks to please others.

• The “Earth” prototype likes and summer, periods during which This type of man responds to His attitude is sincerity and left,

autumn and winter and poorly tolerates spring he is sensitive to attack by perverse energy. the Foot Taiyin (Sp). devotion.

• The “ E a r t h ” prototype is divided as well into 4 morphotypes: top, bottom, right.

1. The “Earth” morphotype modelled on the note Tai Gong (Gong major) is compared to the type associated with the Foot Yangming (St) of the left and to the type responding to the upper part of the Foot Yangming (St). His attitude is conciliation. 2. The “ E a r t h ” morphotype modelled on the note Jia Gong (added √ increased G o n g ) is compared to the type associated with the Foot Yangming (St) of the left and to the type responding to the lower part of the Foot Yangming (St). His attitude is decency and honesty. 3. The “ E a r t h ” morphotype modelled on the note Shao Gong (Gong minor) is compared to the type responding to the Foot Yangming (St) of the right and to the type responding to the upper part of the Foot Yangming (St). His attitude is simplicity and infatuation√ . 4. The “ E a r t h ” morphotype modelled on the note Zuo Gong (Gong of the left) is compared to the type responding to the Foot Yangming (St) of the right and to the type responding to the lower part of the Foot Yangming (St).

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His

attitude is

toiling

and

attentiveness.”

EXPLANATIONS AND COMMENTARIES I - Ma Shi explains: “This paragraph speaks on man of “Earth” prototype grouped into 4 morphotpyes: top, bottom, left, right. 212.

1. Center governs Earth and Earth responds to the principal note “Gong” and to the color yellow. This is why the Earth prototype is compared to the note Shang Gong (upper Gong) and to man of the Center. “The face is round” like the shape of the Earth. “The head is large” because it represents the highest part of Earth. “The shoulders and back are well-developed” because they represent the “thick” nature of Earth. “The abdomen is large” because Earth developed by widening. “The thighs and legs are beautiful” like the force of permeation of the Earth within this part of the body. “The feet and hands are small and tapered√” like the force of permeation of the Earth thinning out at this level. “The flesh in abundance and the body well-proportioned” like the Earth which governs the flesh as much at the top as at the bottom of the body. “Confident gait and stride not very high” like the “slow” nature of the Earth. “Peaceful heart” like the Earth devoid of the quality of revolt. “He looks only to please others” like the power of Earth producing beings and things. “He does not like power” like the benevolent quality of the Earth just as easily to the rich as to the poor. “He likes autumn and winter” like the permeating nature of the humidity of the Earth. “He poorly tolerates spring and summer” like the Earth apprehending dryness. This is why in spring and summer, he is easily attacked by perverse energy. 2. The first part of this paragraph places emphasis on the characteristics of man of “Earth” prototype. The Foot Taiyin (Sp) belongs to Earth-Spleen. As a result, all principal and secondary vessels of the spleen circulate slowly and harmoniously within the organism. 3. The second part of this paragraph addresses the Foot Yangming (St) because the stomach and spleen constitute the “Yin-Yang, Interior-Exterior” system of relationship. _ In the Tai Gong (Gong major) type, of the upper part on the left side, that is to say, at the upper part of the Foot Yangming (St), blood and energy are in abundance, beard and moustache are handsome and long. In contrast, if the blood and energy are in insufficiency, beard and moustache are sparse. Therefore, “the upper part called Yangming (St) is the only site where all energetic and blood vessels belonging to the stomach circulate.” _ In the Jia Gong (increased Gong) type, of the lower part on the left, that is to say, the lower part of the Foot Yangming (St), if the blood and energy are in excess, the hair of the thorax and legs is beautiful. In contrast, • if the blood is in abundance and the energy in insufficiency, the hair is short. • and if the blood and energy are simultaneously in insufficiency, the hair is absent. As a result, “the lower part called Yangming (St) is the only site where all energetic and blood vessels belonging to the stomach circulate”.”

II - N.V.N.: This paragraph speaks on man of the “Earth” prototype compared to the note Shang Gong (upper Gong) responding to the Foot Taiyin (Sp) (Figure 6). The “Earth” prototype, compared to the note Shang Gong (upper Gong) and responding to the Foot Taiyin (Sp), is also divided into 4 morphotypes: top, bottom, left, right, belonging to the Foot Yangming (St) because it is

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in “Yin-Yang, Interior-Exterior” relationship with the Foot Taiyin (Sp). 213.

Figure 6: Man of “Earth” type compared to the note Shang Gong responding to the Foot Taiyin (Sp).

1. The Tai Gong (Gong major) morphotype compared to the Foot Yangming (St) of the left is similar to the type responding to the upper part of the Foot Yangming (St) because this part is the site of physiologic manifestations of the Foot Yangming (St). 214. The attitude of the “Tai Gong” type is of living on good terms. 2. The Jia Gong (increased Gong) morphotype, compared to the Foot Yangming (St) of the left, is similar to the type responding to the lower part of the Foot Yangming (St) because this part is the site of manifestations of the physiologic nature of the Foot Yangming (St).

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Its attitude is solemn and serious. 3. The Shao Gong (small Gong) morphotype compared to the Foot Yangming (St) of the right is similar to the type responding to the upper part of the Foot Yangming (St) because this part is the site of manifestation of the physiologic natures of the Foot Yangming (St). 215. Its attitude is flexibility in order to obtain an accomplished whole of talent and beauty√. 4. The Zuo Gong (Gong of the left) morphotype compared to the Foot Yangming (St) of the right is similar to the type responding to the lower part of the Foot Yangming (St) because this part is the site of appearance of the physiologic natures of the Foot Yangming (St). Its attitude is attentiveness (Figure 7).

PARAGRAPH

5

“The “Metal” prototype, compared to the note Shang behaves like man of the West.

Shang

(upper

Shang),

• He is white in color with square face. The head, shoulders and back are small. The abdomen is straight. The heel bone appears to jut out toward the exterior. The joints are supple and slight. He is watches over the cleanliness of his body. He is of energetic nature. He is predisposed to the academic m a n d a r i n (legal) profession. • He worships autumn and wiinter and poorly tolerates spring and summer. In spring and summer, he is easily attatcked by perverse energy. This “Metal” type belongs to the Hand Taiyin (Lu). His attitude is firmness. • But the man of “ M e t a l ” prototype is also divided into 4 morphotypes: top, bottom, left, right. 1. The “Metal” prototype modelled on the note Tai Shang (Shang major) is compared to the type responding to the Hand Yangming (LI) of the left and to the type responding to the top part of the Hand Yangming (LI). His attitude is cleanliness. 2. The “ M e t a l ” prototype modelled on the note Yuo Shang (Shang of the right) is compared to the type responding to the Hand Yangming (LI) of the left and to the type responding to the bottom part of the Hand Yangming (LI). His attitude is casualness and stubborn pleasantness. 216. 3. The “Metal” prototype modelled on the note Zie Shang (Shang of the left) is compared to the type responding to the Hand Yangming (LI) of the right and to the type responding to the top part of the Hand Yangming (LI). 4. The “ M e t a l ” prototype nodelled on the note Shao Shang (little Shang) is compared to the type responding to the Hand Yangming (LI) of the right and to the

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type reponding to the bottom part of the Hand Yangming (LI). His attitude is solemnity and dignity.”

EXPLANATIONS AND COMMENTARIES I - Ma Shi explains:

“This paragraph speaks on man of the “Metal” type responding to the Hand Taiyin (Lu). West governs Metal, and Metal responds to the note Shang and to the color white. This is why the Metal type is compared to the note Shang Shang (upper Shang) and behaves like man of the West. 1. “Squared face and white color” denote the appearance and constitution of metal. “Small head and straight belly” reflect metal which, upon falling because of his weight, disappears little by little in depth and does not appear little by little toward the surface√. “Heel bone appears to jut out to the exterior” explains the state of hardness of metal. “The joints are slight” because metal does not possess d’entre-noeuds. “He watches over the cleanliness of his body” like the appearance of clean metal without stain. “He is of energetic nature” like the rigidity of metal. “Sometimes he is calm, sometimes he is violently agitated” denotes the peaceful, but very dynamically active, nature of metal. “He tolerates autumn and winter” like the plethoric “metal” energy during periods of cold and coolness. “He does not tolerate spring and summer” because metal fears fire. 2. The Hand Taiyin (Lu) has the ability to consolidate all Yang channels and all blood vessels. 3. The second part of this paragraph addresses the Hand Yangming (LI) because the lung and large intestine constitute the “Yin-Yang, Interior-Exterior” system of relationship. 217. 4. Man of “Tai Shang, Yuo Shang, Zie Shang and Shao Shang” types involve the Jingmai and blood vessels belonging to the Hand Yangming (LI) traveling the body. It is the same for the other types of man cited in the previous paragraphs.”

II - N.V.N.: This paragraph speaks on the man of “Metal” prototype compared to the note “Shang Shang” (upper Shang) responding to the Hand Taiyin (Lu) (Figure 8). • The “Metal” prototype compared to the note Shang Shang and responding to the Hand Taiyin (Lu) is again divided into 4 morphotypes: top, bottom, left, right belonging to the Hand Yangming (LI) because it is in “YinYang, Interior-Exterior” relationship with the Hand Taiyin (Lu). 1. The Tai Shang (Shang major) morphotype compared with the Hand Yangming (LI) of the left is similar to the type responding to the upper part of the Hand Yangming (LI) because it is the site of manifestation of the physiologic characteristics of the type belonging to the Hand Yangming (LI). 218...

His attitude is the pursuit of cleanliness of his body and refusal to allow it to become contaminated.√

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Figure 8: Man of the “Metal” prototype compared to the note Shang Shang and to the Hand Taiyin (Lu).

2. The Yuo Shang (Shang of the left) morphotype compared to the Hand Yangming (LI) of the left is similar to the type responding to the lower part of the Hand Yangming (LI) because this part represents the physiologic characteristics of the type belonging to the Hand Yangming (LI). His attitude is not to hurry and to be agreeable without being obstinate. 219. 3. The Zie Shang (Shang of the left) morphotype comopared to the Hand Yangming (LI) of the right is similar to the type responding to the upper part of the Hand Yangming (LI) because this part represents the physiologic characteristics of the type belonging to the Hand Yangming (LI). His attitude is to pursue reason and blame√. 4. The Shao Shang (Shang minor) morphotype compared to the Hand Yangming (LI) of the right is similar to the type responding to the lower part of the Hand Yangming (LI) because this part is the site of manifestation of the physiologic characteristics of the type belonging to the Hand Yangming (LI). His attitude is formal and ceremonious.

PARAGRAPH 6 179

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“The man of the “ W a t e r ” prototype is compared to the note Shang Yu (upper Yu). He behaves like man of the North. • This type of man is blackish in color with hollow face. The head is large and chin pointed. The shoulders and back are straight. The abdomen is large. The feet and hands are usually agitated. The gait is generally accompanied by balance of the body. The lower part of the lumbar vertebrae to the coccyx is long. The length of the back exceeds everyday norms. He is insolent and deceitful and fears nothing. He is inclined to fool people. He is carries out murder. • He likes autumn and winter and poorly tolerates spring and summer. In spring and summer, he is often attacked by perverse energy. This “Water” type belongs to the Foot Shaoyin (Ki). His attitude is presumption and arrogance. • Man of the “ W a t e r ” prototype is also divided into 4 morphotypes: top, bottom, left, right. 1. The “ W a t e r ” morphotype modelled on the note Tai Yu (Yu major) is compared to the type responding to the Foot Taiyang (Bl) of the right, similar to the type responding to the upper part of Foot Taiyang (Bl). His attitude is unpleasant smugness and arrogance. 220.

2. The “ W a t e r ” morphotype modelled on the note Shao Yu (Yu minor) is compared to the type responding to the Foot Taiyang (Bl) of the left, similar to the type responding to the lower part of the Foot Taiyang (Bl). His attitude is falseness and hypocrisy. 3. The “Water” morphotype modelled on the note Cong Yu (other Yu) is compared to the type responding to the Foot Taiyang (Bl) of the right, similar to the type belonging to the lower part of the Foot Taiyang (Bl). His attitude is sincerity and neatness. 4. The “ W a t e r ” morphotype modelled on the note Zhi Yu (substantial Yu) is compared to the type responding to the Foot Taiyang (Bl) of the left, similar to the type belonging to the upper part of the Foot Taiyang (Bl). His attitude is nobleness and virtue. • In this manner, human morphology responds to the 5 Movements divided into 25 morphotypes. This notion is difficult for the non-specialist physician. This is why he neglects it and ignores the importance of the “ q u a n t i t a t i v e ” state and “ q u a l i t a t i v e ” state of the human being.”

EXPLANATIONS AND COMMENTARIES

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I - Ma Shi explains:

“1 - This paragraph speaks on man of the “Water” prototype responding to the Foot Shaoyin (Ki). North governs Water, and Water responds to the the note “Yu” and to the color black. This is why the “Water” type is compared to the note “Shang Yu” (upper Yu) and behaves like man of the North. “The face is hollow” like the surface of water which undulates. “The head is large” like the surface of water which is not pointed. “The chin is pointed” because water flows out toward the 4 Seas. “Straight shoulders” because water flows out from above downward. Therefore, at its height, water does not widen. “The abdomen is large” because the seas have a large size and expanse enabling them to contain the “thousand things”. “The feet and hands are usually agitated,... the gait is generally accompanied by balance of the body” because the flow of water always stirs up the undulation of waves. “The base of the lumbar vertebrae to the coccyx is long...” because water flows out stretching away√. 221.

“He is insolent and deceitful and fears nothing” like water which itself marks out the path of flow without being able to stop. “He is inclined to fool people” like water which has an unstable quality. “He caaries out murder√” because water can anihilate beings and things. “He like autumn and winter” because during those two seasons, water is not lost. On the contrary, “He poorly tolerates spring and summer.”

The Foot Shaoyin (Ki) responds to Water. As a result, the regions traveled by the kidney channel are of humid and absorbing quality√.

2 - The second part of this paragraph addresses the types of man responding to the Foot Taiyang (Bl) because the kidney and bladder constitute the “Yin-Yang, Interior-Exterior” system of relationship. • The 5 prototypes responding to the 5 Movements and becoming transformed into 25 morphotypes are still unknown to numerous practitioners. As a result, they neglect the importance of the “quantitative” and “qualitative” states of the human being.”

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Figure 10: Man of the “Water” prototype compared to the note Shang Yu and to the Foot Shayin (Ki).

II - N.V.N.:

222....

This paragraph concerns man of the “Water” prototype compared to the note Sang Yu (upper Yu) responding to the Foot Shaoyin (Ki) (Figure 10). • The “Water” prototype responding to the Foot Shaoyin (Ki) is differentiated into 4 morphotypes: top, bottom, left , right belonging to the Foot Taiyang (Bl) because the bladder and kidney constitute one system of “Yin-Yang, Interior-Exterior” relationship. 1. The Tai Yu (Yu major) morphotype compared to the Foot Taiyang (Bl) of the right is similar to the the type responding to the upper part of the Foot Taiyang (Bl) because this part is the site of physiologic manifestations of the Foot Taiyang (Bl). His attitude is unpleasantly conceited and insolent. 223... 2. The Shao Yu (Yu minor) morphotype compared to the Foot Taiyang (Bl) of the left is similar to the type responding to the lower part of the Foot Taiyang (Bl) because this part is the site of physiologic manifestations of the Foot Taiyang (Bl). His attitude is falseness and hypocrisy. 3. The Cong Yu (other Yu) morphotype compared to the Foot taiyang (Bl) of the right is similar to the type responding to the lower part of the Foot Taiyang (Bl) because this part is the site of physiologic manifestations of the Foot Taiyang (Bl). His attitude is sincerity and neatness. 4. The Zhi Yu (substantial Yu) morphotype compared to the Foot Taiang (Bl) of the left is similar to the type responding to the upper part of the Foot Taiyang (Bl) because this part is the site of physiologic

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manifestations of the Foot Taiyang (Bl). His atitude is nobleness and virtue (Figure 11).

222.....

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Figure 11: The 4 tones of Shang Yu and their physiologic characteristics.

PARAGRAPH 7

223....

Huangdi: “What about the individual whose morphology does not respond to color?√ √ ” Qi Bo:

“When form triumphs over color and when color triumphs over form, we must pay attention to these phenomena. In effect, at “Nian Qi” (Year of Dread√ ), attack of perverse energy is a fearsome triggering factor of disease. If the treatment is not appropriate, the disease can cause disturbing problems. In contrast, the concordance of bodily form and color√ √ is the mark of richness and worthiness.” Huangdi: “Bodily form and color√ mutually have a predominant period called “Nian Qi”. Will you explain this to me?”

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Qi Bo: the

“Generally, to speak of “Nian Qi” is to speak of the morphotypes responding to upper part or lower part of the corresponding Jingmai (principal channels).

Nian _ to _ to _ to _ to _ to _ to

Qi starts at 7 years of which one adds 9 years: which one adds 9 years: which one adds 9 years: which one adds 9 years: which one adds 9 years: which one adds 9 years:

age, 7 + 9 = 16 years 16 + 9 = 25 years 25 + 9 = 34 years 34 + 9 = 43 years 43 + 9 = 52 years 52 + 9 = 61 years.

224.

These years constitute “Dai Nian Qi” (Great Years of Dread), periods during which the human being is particularly vulnerable. One must not ignore them in order to protect against perverse energy and maintain good health; otherwise, all attacks will bring about serious diseases and all inadequate treatments will cause alarming problems. Generally, during these periods, one must not exaggerate sexual relations. Such are the preventative years during the life of the human being.”

EXPLANATIONS AND COMMENTARIES N.V.N.: This paragraph involves the discordance between “form” (Xing: morphology) and “color”, indicators revealing disease that can be classified into two groups: 1 - “Victory of form over color”: Ex: Individual of “Wood” prototype with appearance of yellow color. 2 - “Victory of color over form”: Ex: Individual of “Wood” prototype with appearance of black color. In relationship to “Nian Qi”, critical years of prevention, the explanation of Zhang Jing Yue (1563-1640 A.D.) is the following: “The number 7 is the small (Shao) number of Yang. The number 9 is the big (Liao: old) number of Yang. At this “maximal 9” number, the appearance of phenomena of transmutation is the rule. Therefore, the Year of Dread (Nian Qi) manifests every 9 years (counting from the age of 7): 7 + 9 = 16 years 16 + 9 = 25 years 25 + 9 = 34 years 34 + 9 = 43 years 43 + 9 = 52 years 52 + 9 = 61 years... .

PARAGRAPH 8 185

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Huangdi: “You have spoken: _ of the characteristics of the upper part and lower part of the 3 Yang _ and of the excess and insufficiency of blood and energy. Should I base my judgment on your explanations to establish the realtionships between form (Xing) and energy (Qi) ? ” Qi Bo:

“• When the upper part of the Foot Yangming (St) is plethoric in blood and energy, the beard is beautiful and long. In contrast, _ if the blood is insufficient and energy _ if the energy is insufficient and blood _ if the energy and blood are insufficient absent and one observes numerous wrinkles of

abundant, the beard is short. abundant, the beard is scarce. at the same time, the beard is the 2 labial commissures.

• When the lower part of the Foot Yangming (St) is plethoric in blood and energy, pubic hair is beautiful and long, ascending to the thorax. In contrast, _ if the blood is abundant and energy insufficient, pubic hair is not very thick and is short, ascending to the umbilcus. While walking, strides are big. The toes appear not very fleshy. The 2 feet are ice cold. _ if the blood is insuficient and energy abundant, the extremities are predisposed to cold and frostbite. _ if the blood and energy are insufficient at the same time, the pubic hair is absent. If hair exists, it is rare, withered and dried out. Muscular atrophy or paresis of the feet is often observed.”

EXPLANATIONS AND COMMENTARIES I - Ma Shi explans:

“The 8 paragraph above complete the study of the “bodily form” (Xing) proposed by Qi Bo. According to our old masters: “The bodily form is divided into upper and lower regions that can be in a state of emptiness or fullness. 226....

Blood and energy are necessary to maintain the epidermo-dermal system and return heat to the organism. Their circulation follows the Jing (channels) and Mai (vessels) of the regions which are associated with them.”

This is why the study of the 5 human prototypes is based on the 3 Yin of the foot and hand as a function of the 5 Movements and that of the other morphotypes and on the 3 Yang of the foot and hand as a function of their upper and lower parts.”

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II - N.V.N.: From this paragraph, the study of the configuration and external structure√ of the living being is based on the physiologic manifestations of the lower part and upper part of the 3 Yang of the foot and hand. In relationship to the Foot Yangming (St), Zhang Jing Yue’s explanation is the following: “1 - The Foot Yangming (St) starts at the side of the nasal ala, ascends to the root of the nose to join the internal canthus of the eye, follows the lower border of the ocular fossa, descends toward the cheek to penetrate into the gums of the upper maxilla, reappears at the commissure of the lips... hence, the appearance of numerous labial wrinkles in the case of insufficiency of blood and energy contained in this facial segment of the Foot Yangming (St). 227...

2 - The Foot Yangming (St) circultes from above downward. From the point Quilai (St 29). it passes to Qijie (Qichong- St 30) to gather at Tong Jin (reunion of muscular forces of the pelvisMons Veneris) (2). This is why the pubic hair is the manifestation of the energetico-blood power of the Foot Yangming (St). Sometimes, this hair extends to the umbilicus or to the thorax. _ “The strides are big” because the limbs are maintained by the energy of the stomach. _ “The toes do not appear very fleshy and the feet are ice cold” because the energy of the stomach is insuficient there. _ The feet and hands are the “roots” of the Yang channels. As a result, in the event of insufficiency of Yang energy, the toes are fleshless and easily attacked by perverse cold. 2. Mons pubis: prominence over the pubic symphysis.

_ In the insufficiency of blood with excess of energy, “cold-edema” manifests at the lower region of the body. _ The Foot Yangming (St) is the “sea” of the 5 organs and 6 bowels. It humidifies Tong Jin (pelvic muscles: Mons Veneris) and maintains the joints. Therefore, the simultaneous insufficiency of blood and energy in the lower parts of the body is a determining factor of paralysis and algoparesthesia (Bi) of the lower limbs.” (Figure 12).

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Figure 12: Qijie (St 30) and Mons Veneris (Tong Jin).

PARAGRAPH 9 “1 - When the upper part of the Foot Shaoyang (GB) is full of blood and energy, the beard (sideburns and moustache) is beautiful and long. If blood is abundant and energy insufficient, the beard is beautiful but short. If blood is insufficient and energy abundant, the beard is sparse. If blood and energy are both insufficient, the beard is absent. Attack of Cold-Humidity often causes “Bi” (algoparesthesia), ostealgia and dryness of the nails. 2 - When the lower part of the Foot Shaoyang (GB) is full of blood and energy, the hair of the leg is beautiful and long and the external malleoli are large. If blood is abundant and energy insufficient, the hair of the legs is beautiful but short, and the external malleoli are covered by a firm and thick skin. If blood is insufficient and energy abundant, the hair of the legs is sparse and the skin of the external malleoli is thin and supple. If blood and energy are both insufficient, the hair of the legs is absent and the external malleoli are small and thin.”

EXPLANATIONS AND COMMENTARIES

228.

N.V.N.: We quote the explanation of Zhang Jing Yue: “The Foot Shaoyang (GB) starts at the external canthus of the eye, descends towards the maxillary condyle in front of the tragal indentation, reaches above the angle of the hairline at the upper part of the temple... . This is why the insufficiency or excess of energy and blood of the Foot Shaoyang (GB) has affect on the growth of the beard.

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The Foot Shaoyang (GB) goes back down the external side of the thigh and arrives below and in front of the peroneal head, runs alongside the outer leg, arrives in front of the external malleolus... . As a result, its influence bears on the external side of the leg.”

PARAGRAPH 10 “1 - When the upper part of the Foot Taiyang (Bl) is abundant in blood and energy, the eyebrows are beautiful and long. In contrast, _ if blood is abundant and energy insufficient, the eyebrows are withered and the face is full of wrinkles, _ if blood is insufficient and energy abundant, the face is fleshy, _ if blood and energy are balanced, the countenance√ is beautiful. 2 - When the lower part of the Foot Taiyang (Bl) is full of blood and energy, the flesh of the level of the heel is full and firm. In contrast, _ if energy is insufficient and blood abundant, the heel is thin and devoid of flesh, _ if energy and blood are both insufficient, they cause cramps and pain of the heel.”

EXPLANATIONS AND COMMENTARIES N.V.N.: The explanation of Zhang Jing Yue is the following: “1 - The Foot Taiyang (Bl) starts at the internal canthus of the eye, reaches the external tip of the eyebrow... . A secondary branch ascends the to the cranium and goes back down to the face where it links with the nose... . This is why disturbances of this branch of the Foot Taiyang (Bl) affects the eyebrows and face.

2 - Below, the Foot Taiyang (Bl) reaches the popliteal fossa, reaches the calf, passes behind the external malleolus, unites with the heel... . This is why disturbances of this lower part of the Foot Taiyang (Bl) affects the heel.”

PARAGRAPH 11 “1 energy, In _ _

229.

- When the upper part of the Hand Yangming (LI) is full of blood and the moustache is beautiful. contrast, if blood is insufficient and energy abundant, the moustache is withered, if blood and energy are both insufficient, the moustache is absent.

2 - When the lower part of the Hand Yangming (LI) is full of blood and energy, the subaxillary hair is abundant and the thenar eminence is fleshy and

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warm. In contrast, _ if blood and energy are both insuficient, the forearm and tenar eminence are thin and cold.”

EXPLANATIONS AND COMMENTARIES N.V.N.: The explanation of Zhang Jing Yue is the following: “1 - Above, the Hand Yangming (LI) passes to the cheek, arrives at the upper maxilla, encircles the upper lip, crosses the same contralateral channel, ascends toward the base of the nostril of the opposite side... . This is why the emptiness and fullness of blood and energy manifest at the level of the moustache.

2 - Below, the Hand Yangming (LI) passes to the angle formed by the two metacarpals, runs alongside the postero-external surface (energetic description) of the raduis, goes into (Yin-Yang. Interior-Exterior” relationship with the Hand Taiyin (Lu). This is why the emptiness and fullness of this lower part of the Hand Yangming (LI) manifests at the level of the thenar eminence, forearm and subaxillary region.”

PARAGRAPH 12 “1 - When the upper part of the Hand Shaoyang (SJ) is full of blood and energy, the eyebrows are beautiful and long and the coloration of the ear pinna is beautiful (shiny). In contrast, if blood and energy are both insufficient, the 2 ears are dried out and the coloration of the ear pinna is unattractive (dull). 2 - When the lower part of the Hand Shaoyang (SJ) is full of blood and energy, the back of the hand is fleshy and warm. In contrast, _ if blood and energy both insufficient, the back of the hand is fleshless and cold, _ if energy is insuficient and blood abundant, the back of the hand is thinned with the appearance of numerous venous vessels.” EXPLANATIONS AND COMMENTARIES

230.

N.V.N.: The explanation of Zhang Jing Yue is the following: “1 - Above, the Hand Shaoyang (SJ) reaches behind the ear, deeply penetrates into the ear, reappears in front of and above the tragus, encircles the lower maxilla, ascends to the orbital edge... . This is why the emptiness and fullness of blood and energy of this part of the channel manifests at the level of the eyebrows and ears.

2 - Below, the Hand Shaoyang (SJ) starts at the external ungual angle (energetic description) of the fourth finger, passes to the dorsal surface of the hand... . This is why disturbances of this lower part of the channel affects this region.”

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PARAGRAPH 13 “1 - When the upper part of the Hand Taiyang (SI) is full of blood and energy, the beard is abundant and long and the face consistent. In contrast, if blood and energy are both insufficient, the face is thin and complexion withered (dark). 2 - When the lower part of the Hand Taiyang (SI) is full of blood and energy, the muscles of the palm of the hand are full. In contrast, if blood and energy are both insufficient, the palm of the hand is thin and cold.” EXPLANATIONS AND COMMENTARIES N.V.N.: The explanation of Zhang Jing Yue is the following: “1 - Above, the Hand Taiyang (SI) arrives behind the inferior maxillary angle where it divides into 2 branches: the first passes to the internal canthus of the eye and goes into relationship with the zygomatic bone; the second reaches the external canthus of the eye and is directed toward the ear... . This is why the emptiness and fullness of blood and energy of the upper part of this channel manifests a the chin (beard) and face.

2 - Below, the Hand Taiyang (SI) runs alongside the external side of the hand, reaches the wrist... . This is why disturbances of this lower part of the channel affects the palm of the hand.”

PARAGRAPH 14

231.

Huangdi: “Are there very specific acupuncture rules reserved for these 25 morphotypes?” Qi Bo:

“Abundant eyebrows originate from the abundance of blood and energy of the Foot Taiyang (Bl) and eyebrows in a poor state (withered), from the insufficient state of blood and energy of the Foot Taiyang (Bl). Fat body and dark (dull) color of the skin result from the loss of energy and blood. As a consequence, to carefully observe the excess or insufficiency of the form (Xing) and energy (Qi) in order to apply the method of regularization is to know the reason of “ C o n t r a r y / F a v o r a b l e ” (Ni Zuan). ”

EXPLANATIONS AND COMMENTARIES

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I - Ma Shi:

“This paragraph speaks on the configuration and external structure of the living being, taking the Foot Taiyang (Bl) as example, in order to study the state of emptiness and fullness of blood and energy, This dissertation constitutes, in summary, a model of practice of acupuncture. The Foot Taiyang (Bl) goes from the head to the foot, passing the back. That of the right and that of the left total 126 (3). This is why, one can determine the state of blood and energy of the entire body as a function of this channel. The upper part of this channel manifests at the eyebrows, and its lower part, also at the eyebrows. As a result, the beauty of the eyebrows is the indicator revealing the state of abundance of blood and energy and their unattractiveness confirms the state of deficiency of 3. In our time, the Foot Taiyang (Bl) of the right and left totals 67 X 2 = 134 points.

these blood and energetic components of the body. “Fat body and shiny color” is the sign of excess blood and energy. In contrast, if the body is fat with dull color, it is the indicator of excess of energy and insuficiency of blood. “Thin body with dull color” indicates the concommitant insufficiency of blood and energy. • In practice, it is necessary to know how to determine the Form (Xing) and energy (Qi) in order to disperse in the event of fullness and to tonify in the event of emptiness. To act in this manner is “favorable” (Zuan), to act otherwise is “contrary” (Ni).”

II - N.V.N.:

232.

This paragraph addresses the problem of emptiness and fullness of blood and energy whose regulation consists of respecting the reason of “Contrary/Favorable” (Ni Zuan). Qi Bo uses the Foot Taiyang (Bl) as example because it represents the Yang channels. In effect: Cold is Heaven. Water is Earth. Jing Qi (energetic quintessence) is man. Therefore, the Foot Taiyang (Bl) responding to Water-Cold is at the same time “master” of the energy of the Yang channels and of Jing-Xue (energetic quintessence and blood).

PARAGRAPH 15 Huangdi: “How do you treat diseases located at the level of the Yin channels and Yang channels?” Qi Bo:

“First, one must examine Cun Kou (radial pulse) and Renying (carotid pulse) to detemine the state of mptiness/Fullness of Yin and Yang in order to apply the method of regularization. Next, with the finger, palpate the length of the Jingluo (principal and secondary channels) to evaluate the state of stagnation/ accumulation of blood and energy, causal factor of “Tong Bi” (algoparesthesia) which, in serious cases, prevents walking.

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The treatment consists of calling on the Yang energy to heat up the places of condensation/stagnation; the needles are left in place a long time. • Obstruction of the Luomai (Luo vessels) results from the engorgement of the Jingmai (pirncipal channels). On must employ the method of “dispersion of the blood” (bleeding technique) in order to aerate the Luomai and reestablish the circulation of blood. • The disease can be localized at the top of the body or down below. At the top, when the energy is excessive, one must bring it toward the bottom. Down below, when the energy is excessive, one must bring it toward the top. In these two cases, massage therapy and the technique of the needles left in place are indicated. If, despite the needles left in place, the energy does not arrive, one must combine this with the technique called “to go against/in opposition” . 233.

• It is then necessary to go deeply into the Jing Sui (deep routes, canals) in order to be able to practice acupuncture effectively. In the case of confrontation with the cold and heat, one must help the blood and energy to circulate. In the case of obstruction at the level of the channels without stagnation of blood and energy (located outside the channel), one must base one’s judgment on the bodily structure to apply treatment by acupuncture. In this manner, to know the 25 morphotypes and the localization of blood and energy, above and below, to the left and right (with diagnostic purpose) is to understand the therapeutic rules of acupuncture.”

EXPLANATIONS AND COMMENTARIES N.V.N.: 1 - Cun Kou (radial pulse) belongs to the Hand Taiyin (Lu) whose energy activates the circulation of the 3 Yin.

Renying (carotid pulse) belongs to the Foot Yangming (St) whose energgy controls the circulation of the 3 Yang. Therefore, Cun Kou governs the interior and represents Yin energy, and Renying also governs the interior and represents Yang energy, In the normal state, Cun Kou and Renying maintain their equilibrium, and in the presence of disease they are directed toward emptiness or fullness (4). 2 - In the “Bi” syndrome (algoparesthesia), stagnation of blood and energy prevents the arrival of Yuan Qi (source energy, vital or essential energy). This is why one must utilize the tecnique of”needle left in place” and know how to wait for the arrival of the energy. 3 - In the excess of energy of the upper part of the body, one must needle the points located down below in order to bring the energy toward the bottom. In the insufficiency of the energy of the upper part of the body, one must needle the points located above in order to make the energy ascend toward the top; the needles must remain in place unitl the arrival of the energy.

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4 - In order to perfect the practice of acupuncture, it is necessary therefore to acquire a deep knowledge of the circulation of blood and energy, in particular those of the internal vessels (Jing Sui) of the 25 biotypes described in this chapter of the Lingshu. 4. Consult notably Chapter 9 (“Beginning and Ending”) and Chapter 48 (“Prohibition and Submission”). no 234/235.

CHAPTER LXV The 5 Musical Notes and 5 Sapors (Wu Yin Wu Wei)

This Chapter 65 of the Lingshu completes the previous one. The morphotypes responding to Wu Yin (5 musical notes) are described as a function of the Yang channels of the foot and hand and as a function of the 5 organs with their therapeutic principle. The 5 Cereals, 5 Fruits and 5 Sapors... each possess a specific action on the harmonization of the energy of the 5 Organs and their channels, also addressed. One part of this chapter is focused on the indication and contraindication of some sapors (foods) in the morphotypes responding to the Wu Yin (5 musical notes). This is why this chapter is entitled: “The 5 Musical Notes and 5 Sapors” (Wu Yin Wu Wei). Another part of this chapter speaks on the reason for the absence of moustache and beard in women and eunuchs and raises the problem of “emptiness” and “fullness” of blood and energy at the level of the Jingmai, fundamental notions of the practice of acupuncture. This chapter consists of 3 paragraphs.

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PARAGRAPH 1 “1. The morphotypes Yuo Zhi (Zhi of the right) and Shao Zhi (Zhi minor) belonging to the “Fire” note must be treated at the upper part of the Hand Taiyang (SI) of the right responding to Fire. 2. The morphotypes Yuo Shang (Shang of the left), belonging to the “Metal” note, and Yuo Zhi (Zhi of the right), belonging to the “Fire” note, must be treated at the upper part of the Hand Yangming (LI) of the left responding to Metal. 236.

3. The morphotypes Shao Zhi (Zhi minor) , belonging to the “Fire” note, and Tai Gong (Gong major), belonging to the “Earth” note, must be treated at the upper part of the Hand Yangming (LI) of the left responding to Metal. 4. The morphotype Yuo Jiao (Jiao of the right) and Tai Jiao (Jiao major) belonging to the “Wood” note must be treated at the lower part of the Foot Shaoyang (GB) of the left responding to Wood. 5. The morphotypes Tai Zhi (Zhi major) and Shao Zhi (Zhi minor) belonging to the “Fire” note must be treated at the upper part of the Hand Taiyang (SI) of the left responding to Fire. 6 - The morphotypes Cong Yu (other Yu) and Shao Yu (Yu minor) belonging to the “Water” note must be treated at the lower part of the Foot Taiyang (Bl) of the left responding to Water. 7 - The morphotypes Shao Shang (Shang minor) and Yuo Shang (Shang of the r i g h t ) belonging to the “Metal” note must be treated at the lower part of the Hand Taiyang (SI) of the right responding to “Fire”. 8 - The morphotypes Zhia Yu (substantial Yu) and Cong Yu (other Yu) belonging to the “Water” note must be treated at the lower part of the Foot Taiyang (Bl) of the right responding to Water. 9 - The morphotypes Shao Gong (Gong minor) and Tai Gong (Gong major) belonging to the “Earth” note must be treated at the lower part of the Foot Yangming (St) of the right responding to Earth. 10 - The morphotypes Fan Jiao (half Jiao) and Shao Jiao (Jiao minor) belonging to the “Wood” note must be trested at the lower part of the Foot Shaoyang (GB) of the right responding to Wood. 11 - The morphotypes Tai Shang (Shang major) and Shang Shang (upper S h a n g ) belonging to the “Metal” note must be treated at the lower part of the Foot Yangming (St) of the right responding to “Earth”. 12 - The morphotypes Tai Shang (Shang major) , belonging to to the “Wood”note, and Shang Jiao (upper Jiao), belonging to the “Wood” note, must be

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treated at the upper part of the Foot Taiyang (Bl) of the left responding to “Water”.

EXPLANATIONS AND COMMENTARIES I - Ma Shi explains:

237.

“Chapter 65 completes the previous one, “Yin and Yang and the 25 Morphotypes” and describes their relationship with the 5 Movements. The 1st paragraph of this chapter is composed of 12 clauses concerning the 25 morphotypes and their treatment. The 2nd paragraph is composed of 5 clauses concerning the 5 prototypes and their corresponding foods. The 3rd paragraph is divided into 12 clauses concerning the similarity of certain morphotypes and their treatment. In total: _ 12 clauses for the “Jiao” (Wood) prototype, _ 6 clauses for the “Zhi” (Fire) prototype, _ 8 clauses for the “Gong” (Earth) prototype, _ 8 clauses for the “Shang” (Metal) prototype, _ 7 clauses for the “Yu” (Water) prototype among which a) some are repeated Examples: The upper part of the Hand Yangming (LI) of the left, The lower part of the Foot Taiyang (Bl) of the right, The lower part of the Foot Yangming (St) of the right, The lower part of the Foot Shaoyang (GB) of the left... . b) some are missing Examples: The lower part of the Hand Yangming (LI) of the left, The upper pat of the Hand Yangming (LI) of the left. c) some are not in accord with the notions of 5 Yin (musical notes), Upper/Lower, Left/Right and the 5 Movements. These errors are certainly due to the difficulty in deciphering the ancient texts and especially due to the limited knowledge of energetic medicine on the part of transcribers and translators... . Such mistakes in the transmitted copies! I am content to copy this chapter in its entirety, without commentary, because only the Sages themselves could rectify them.”

II - N.V.N.: This paragraph is the logical continuation of the previous one. 1. One bases one’s judgment on the “upper/lower” and “left/right” responding to the “5 Yin” (5 basic musical notes) in order to establish the relationships of the morphotypes with the 3 Yang channels of the foot and hand to determine an adequate therapy. In this way, for example: • Yuo Zhi (Zhi of the right) and Shao Zhi (Zhi minor) responding to the “Fire” note and the Hand Taiyang

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(SI) also responding to the “Fire” note are the basic notions for a therapy which uses the “Fire” note in individuals of “Fire” morphotype. • Called “Yuo Zhi (Zhi of the right), it is is associated with the “Fire” prototype decribed in the previous chapter with numerous details on the physiology of blood and energy. In order to understand this paragraph, it is therefore necessary to delve deeply into the previous Chapter 64 (“Yin and Yang and the 25 Morphotypes”). 238.

2. Nevertheless, it is noted that some morphotypes belonging to the “Left/Right”, Upper/ Lower” type responding to the “5 Yin” (5 basic notes) and linked to the 5 Movements cited in Chapter 64 are not always in accord with those described in this paragraph. In this way, for example: • Shao Shang (Shang minor) and Yuo Shang (Shang of the right), associated with the “Metal” note, and the Hand Taiyang (SI) responding to the “Fire” channel are treated at the level of the “Metal” channel. This error is most certainly due to confusing the Hand Yangming (LI) and Hand Taiyang (SI). • Tai Shang (Shang major) and Shang Shang (upper Shang) are treated at the level of the lower part of the Foot Yangming (St) of the right, while according to Chapter 64, they must be treated at the level of the upper part of the Hand Yangming (LI) of the left. They are obviously gross errors on the part of transcribers and translators that persisted down the line/as a theme over the centuries√.

PARAGRAPH 2 “1. The morphotypes Shang Zhi (upper Zhi) and Yuo Zhi (Zhi of the right), like the “Fire” prototype, correspond to: _ _ _ _ _ _ _ _

w h e a t √ √ among the 5 cereals l a m b among the 5 animals a p r i c o t among the 5 fruits the Hand Shaoyin (He) among the 12 Jingmai the h e a r t among the 5 organs r e d among the 5 colors bitter among the 5 sapors s u m m e r among the 5 seasons.

2. The morphotypes Shang Yu (upper Yu) and Tai Yu (Yu major), like the “Water” prototype, correspond to: _ black bean among the 5 cereals _ pork among the 5 animals _ chestnut among the 5 fruits _ t h e Foot Shaoyin (Ki) among the 12 Jingmai _ the k i d n e y among the 5 organs _ b l a c k among the 5 colors _ salty among the 5 sapors _ w i n t e r among the 5 seasons. 3. The morphotypes Shang Gong (upper Gong) and Tai Gong (Gong major), like the “ E a r t h ” prototype, correspond to:

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_ _ _ _ _ _ _ _

millet√ √ among the 5 cereals beef among the 5 animals j u j u b e among the 5 fruits the Foot Taiyin (Sp) among the 5 Jingmai the s p l e e n among the 5 organs y e l l o w among the 5 colors s w e e t among the 5 sapors end of summer among the 5 seasons.

4. The morphotypes Shang Shang (upper Shang) and Yuo Shang (Shang of the r i g h t ) , like the “Metal” prototype, correspond to: _ _ _ _ _ _ _ _

sticky rice among the 5 cereals chicken among the 5 animals peach among the 5 fruits the Hand Taiyin (Lu) among the 12 Jingmai the l u n g among the 5 organs white among the 5 colors spicy among the 5 sapors a u t u m n among the 5 seasons.

5. The morphotypes Shang Jiao (upper Jiao) and Tai Jiao (Jiao major) , like the “ W o o d ” prototype, correspond to: _ _ _ _ _ _ _ _

s e s a m e among the 5 cereals d o g among the 5 animals plum among the 5 fruits the Foot Jueyin (Li) among the 12 Jingmai the liver among the 5 organs g r e e n among the 5 colors sour among the 5 sapors spring among the 5 seasons.”

EXPLANATIONS AND COMMENTARIES N.V.N.: This paragraph speaks on the correspondences between the morphotypes responding th the Wu Yin (5 musical notes) and the “5 cereals, 5 animals, 5 fruits, 5 colors, 5 seasons... “ in order to establish a group of principles and methods of dietary regimes with a therapeutic purpose, as clarified by Ma Shi: “Individuals of “Shang Zhi” (upper Zhi ) and “Yuo Zhi” (Zhi of the right) types are morphotypes responding to the note “Fire”. This is why, among the 5 cereals, 5 fruits, 5 animals... wheat, apricot, lamb... endowed with calorific (fire) properties, are used to treat these types of man.” 240.

We present below a summary table of diets in the 5 groups of morphotypes cited in this paragraph. Summary table of diets applied in the 5 groups of morphotypes.

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Individuals responding to 5 Yin

5 Movement s

5 Cereals

5 Animals

5 Fruits

Jingmai

5 Organs

5 Colors

5 Sapors

5 Seasons

Shang Zhi, Yuo Zhi

Fire

Wheat

Lamb

Apricot

Hand Shaoyin (He)

Heart

Red

Bitter

Summer

Shang Yu, Tai Yu

Water

Black Bean

Pork

Chestnut

Foot Shaoyin (Ki)

Kidney

Black

Salty

Winter

Shang Gong, Tai Gong

Earth

Millet

Beef

Jujube (Pear)

Foot Taiyin (Sp)

Spleen

Yellow

Sweet

End of Summer

Shang Shang Yuo Shang

Metal

Sticky Rice

Chicken

Peach

Hand Taiyin (Lu)

Lung

White

Spicy

Autumn

Shang Jiao, Tai Jiao

Wood

Sesame

Dog

Plum

Foot Jueyin (LI)

Liver

Green

Sour

Spring

PARAGRAPH 3 “1. The morphotypes Tai Gong (Gong major) and Shang Jiao (upper J i a o ) are treated at the upper part of the Foot Yangming (St) of the right. 2. The morphotypes Zie Jiao (Jiao of the right) and Tai Jiao (Jiao major) are treated at the upper part of the Foot Yangming (St) of the left. 3. The morphotypes S h a o Yu (Yu minor) and Tai Yu (Yu major) are treated at the lower part of the Foot Taiyang (Bl) of the right.

the

4. The morphotypes Zie Shang (Shang of the left) and Yuo Shang (Shang of right) are treated at the upper part of the Hand Yangming (LI) of the left.

5. The morphotypes Jia Gong (increased Gong) and Tai Gong (Gong major) are treated at the upper part of the Foot Shaoyang (GB) of the left. 6. The morphotypes Zhi Fan (half Zhi) and Tai Gong (Gong major) are treated at the lower part of the Hand Taiyang (SI) of the left. 7. The morphotypes Fan Jiao (half Jiao) and Tai Jiao (Jiao major) are treated at the lower part of the Foot Shaoyang (GB) of the left. 8. The morphotypes Tai Yu (Yu major) and Tai Jiao (Jiao major) are treated at the upper part of the Foot Taiyang (Bl) of the right. 9. The morphotypes Tai Jiao (Jiao major) and Tai Gong (Gong major) are treated at the upper part of the Foot Shaoyang (GB) of the right. • The 5 morphotypes: Yuo Zhi, Shao Zhi, Zhi Zhi, Fan Zhi and 2 4 1 . Shang Zhi belong to Fire. • The 5 morphotypes: Yuo Jiao, Di Jiao, Shang Jiao, Tai Jiao and Fan Jiao belong to Wood. • The 5 morphotypes: Yuo Shang, Shao Shang, Di Shang, Shang Shang and Zie S h a n g belong to Metal. • The 5 morphotypes: Shao Gong, Shang Gong, Tai Gong, Jia Gong and Zuo Gong

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belong to Earth. • The 5 morphotypes: Cong Yu, Zhi Yu, Shang Yu, Tai Yu and Shao Yu belong to Water,”

EXPLANATIONS AND COMMENTARIES N.V.N.: 1. Tai Gong and Shang Jiao are treated at the upper right part of the Foot Yangming (St). Ma Shi wonders: “Tai Gong responds to Earth and the treatment must be carried out at the level of the Foot Yangming (St) (Stomach=Earth). What is the reason why this paragraph also adds Shang Jiao which responds to Wood? I do not understand.” Zhang Shi replies: “The Foot Yangming (St) and Foot Jueyin (Li) join and communicate at the level of the neck (laryngopharyngeal region) and within the nasal cavity. Therefore, man of the “Tai Gong” type and that of “Shang Jiao” type can be treated at the level of the Foot Yangming (St).” 2. Zie Jiao and Tai Jiao are treated at the upper left part of the Foot Yangming (St). Ma Shi asks: “Jiao”, belonging to the “Wood” note, must be treated at the level of Wood (Liver). Why can the Foot Yangming (St) also treat Wood? I do not understand.” Here is Zhang Shi’s explanation: “The Foot Shaoyang (GB) and Foot Yangming (St) are vessels which join and communicate at the level of the lower maxillary angle where Jiache (St 6) is found. As a result, Zie Jiao and Tai Jiao can be treated at the level of the Foot Yangming (St).” 3. The Shao Yu and Tai Yu types are treated at the lower right part of the Foot Taiyang (Bl). Zhang Shi explains: 242. “Shao Yu and Tai Yu respond to Water. As a result, they are treated at the lower right part of the Foot Taiyang (Bl).” 4. Zie Shang and Yuo Shang are treated at the upper left part of the Hand Yangming (LI). Zhang Shi clarifies: “Zie Shang and Yuo Shang belong to the “Metal” note. Therefore, they are treated at the level of the Hand Yangming (LI).” 5. Jia Gong and Tai Gong are treated at the level of the left part of the Foot Shaoyang (GB). Ma Shi asks: “Jia Ging and Tao Gong belongs to the “Earth” note. I do not know why one treats them at the level of the Foot Shaoyang (GB).” Zhang Shi explains: “Jia Gong and Tai Gong are compared to the Foot Yangming (St=Earth) which reaches the face and exteriorizes in front of the ear and unites with the Foot Shaoyang (GB) at the point Gua Shu Ren (GB 3: other name Shangguan). Therefore, Jia Gong and Tai Gong are treated at the level of the Foot Shaoyang (GB).” 6. Zhi Fan and Tai Gong are treated at the lower left part of the Hand Taiyang (SI). Ma Shi wonders: “Zhi Fan (half Zhi), belonging to the “Fire” note, must be treated at the level of the Hand Taiyang (SI). I understand it perfectly. But why can Tai Gong (Gong major), responding to the “Earth” note, also be treated at

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this level?” Zhang Shi explains: “The Hand Taiyang (SI) reaches the neck... a branch follows the laryngo-pharyngeal system, crosses the diaphragm, arrives at the stomach... runs alongside the anterior part of the leg to unite at the point Xiajiuxu (St 39: other name Xialian), site of its exteriorization and also site of “reunion-meeting” of the Hand Taiyang (SI) and Foot Yangming (St). This is why Tai Gong (Gong major) responding to the “Earth” note can be treated at the level of the Hand Taiyang (SI).” 7. Fan Jiao (half Jiao) and Tai Jiao (Jiao major) are treated at the lower left part of the Foot Shaoyang (GB). Gu You Lim states: “It concerns a technique called “Upper/Lower, Left/Right” using the same energy to treat the same channel which can be located above or below, to the left or right.” 8. Tai Yu (Yu major) and Tai Jiao (Jiao major) are treated at the upper right part of the Foot Taiyang (Bl). 243.

Ma Shi wonders: “Tai Yu (Yu major) responds to the “Water” note. I understand perfectly that the treatment must be carried out at the level of the Foot Taiyang (Bl). But why can Tai Jiao (Jiao major), responding to the “Wood” note, also be treated at this level? Zhang Shi explains: “At the cranium, the Foot Taiyang (Bl) possesses vessels that communicate with the Foot Shaoyang (GB) at the points Shuaigu (GB 8), Fubakl (GB 10), Qiaoyin (GB 11)... . They are the routes of “reunion-meeting” located at the cephalic region of the 2 channels Foot Taiyang (Bl) and Foot Shaoyang (GB). Therefore, Tai Yu (Yu major) and Tai Jiao (Jiao major) are treated at the level of the upper part of the Foot Taiyang (Bl).” 9. Tai Jiao (Jiao major) and Tai Gong (Gong major) are treated at the upper right part of the Foot Shaoyang (GB). Zhang Shi specifies: “Blood and energy of the epidermo-dermal layer are devoted to the production of hair and beard and to warming up the organic, sweat gland, musculoskeletal and medullary systems... . All have their source at the level of Jing Qi (quintessence of energy) coming from Shui Gu (Cereal/ Water) at the level of the stomach. This Jing (quintessence) circulates from the Great Luo (Da Luo) of the stomach. It follows the deep route of the organs and bowels to exteriorize and permeate the pilo-cutaneous system...”. In conclusion: a) In relation to the treatment of Tai Jiao (Jiao major) and Tai Gong (Gong major) types, Zhang Shi’s explanation does not conform to the text. It is certainly a question of an omission by transcribers. b) Zhang Shi’s explanation allows us to understand the importance of the “reunionmeeting” points in daily practice.

PARAGRAPH 4 Huangdi: “In women, is the absence of beard and moustache due to the absence of blood and energy?” Qi Bo:

“The C h o n g m a i and Renmai (CV) start at the level of the uterus. In the interior, the Chongmai ascends the length of the antero-internal surface of the lumbar spine to constitute the “sea” of the Jingluo (principal and secondary

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channels). At the exterior, these two channels, C h o n g m a i and Renmai (CV) , pass alongside the abdomen to unite with the laryngo-pharyngeal system where a vessels which penetrates deeply into the mouth departs from. 244.

In the plethoric state, blood and energy maintain the pilo-cutaneous system and heat up the “flesh” system. If the blood alone is abundant, it permeates the skin and produces hair. In women, the excessive state of the energy and insufficient state of blood are natural phenomena originating from the repeated and cyclic loss of blood during menstruation. When the C h o n g m a i and Renmai (CV) can no longer produce hair, beard and moustache are absent.”

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains:

“This paragraph completes the previous one in speaking on the decanting of the energy at the level of the pilocutaneous system in order to heat up all organic systems (sweat gland, musculoskeletal, medullary...). This energy coming from the kidneys starts at the level of the uterus (Bao Chong). It follows the path of the Renmai (CV) and Chongmai to reach the interior od the vessels. 1. The previous paragraph speaks on the blood and energy which, originating from the stomach, circulates first within the Dao Luo (Great Luo) of the stomach, then within the Jingmai (principal channels) and finally within the Xun Luo (little luo or energetic capillaries) in order to permeate the pilocutaneous system. This energy is nine other than Jing Qi (a posteriori energetic quintessence) conducted by the Chongmai. 2. This paragraph speaks particularly on the energy and blood of the uterus circulating from the Chongmai and Renmai (CV) in order to reach the interior and exterior of the Jingmai (principal channels). This energy is the a priori Jing Qi conducted by the Xiajiao (Lower Jiao- LJ). 3. In summary, blood and energy of the human being aimed at maintaining the skin, vessels, flesh, muscles, bones... all begin from the “Qian” palace ( ; Heaven) and from the “Kun” palace ( ; Earth); that is to say that they all have their innate source (Heaven; respiration) and their acquired source (Earth; alimentation). 4. The uterus (Bao Chong) is the “sea” of blood. It is the Shaoyin (Ki) which commands it under the action of the Xiajiao (LJ). The Chongmai and Renmai (CV), passing via the uterus, have internal vessels called “Fu Chong” (1) reaching the antero-internal part of the spine and playing the role of “sea” of the Jingluo (principal and secondary channels). 5. The previous paragraph speaks on the blood and energy, generative sources of the beard and hair conducted by the 3 Yang channels, while this one deals with the problem of blood and energy attracted by the Chongmai and Renmai (CV) toward the buccal region in order to produce beard and moustache. The production and circulation of blood and energy are therefore very complex. This is why their misunderstanding naturally leads to therapeutic errors.” 245.

II - N.V.N.:

“Bao Chong”: “envelope of the center” designates the uterus in women; this “curious” bowel, located

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within the pelvic cavity and intended to contain the fertilized egg until its complete development, bears the name “Bao” (envelope). This curious bowel is also the site of departure of the Chongmai, Dumai (GV) and Renmai (CV) coming from the kidney. It also baers the name “One Root of Three Branches”. • The Bao Chong (uterus) constitutes an extermely important chapter in the energetic physiology of the female. According to Yi Jing Jing Yi (explanations and commentaries of the “Classic of Mutations”): “The Bao Chong also bears the name “Qi Hai” (“sea” of energy) because it is the root of respiration (due to its direct connection with the kidney and lung). Expiration follows the route of Qi Hai to the diaphragm and thorax, reaches the lung and exteriorizes at the level of the laryngo-pharyngeal system. This route is that of the Chongmai which goes toward the top. This is why the Nejing has said: “The Chongmai is a true path of Qijie (exteriorization of the energy).” • Acording to Zhang Jing Yue: “The Bao Chong also bears the name “Xue Hai” (“sea” of blood). In effect, dietary Jing originating from the stomach maintains the heart which transforms it into blood and makes it descend to the Bao Chong (uterus) via the path of the Chongmai.” • For this reason, the Suwen (Chapter 1, “Ancient Celestial Origin”) has stated (as we have already recalled in Chpater 54 (“Celestial Age”), page 75 ): “In girls, at 7 years of age, the energy of the kidney is full, the milk teeth change, the hair grows longer. _ At age 7 X 2 = (14 years), Celestial Gui” enters into play, the Renmai (CV) circulates abundantly, the Chongmai is prosperous, menses becomes manifest according to a specific cycle, the young girl can conceive... . _ At age 7 X 7 = (49 years), the Renmai (CV) is in insufficiency, the Chongmai grows weaker, Celestial Gui disappears, Di Dao (subterranean route, pelvic routes) are obstructed. This is why the body becomes exhausted, the woman can no longer conceive... .” This assertion clarifies the phenomenon of maturity and recession of menstrual function in women. Menses is therefore a function of the prosperity or poverty (of blood) of the 2 channels, Chongmai and Renmai (CV). 1. See Chapters 54 (“Celestial Age”) and 79 (“Years and Dew”).

Zhang Jing Yue specifies: 246. “The Chongmai and Renmai (CV) are the “sea of blood”. The beard makes up part of blood. When blood and energy are insufficient, the Chongmai and Renmai (CV) no longer maintain the buccal region, hence the absence of a beard.” • “Celestial Gui” designates the 10th Celestial Stem, corresponding to Water. Among the Celestial Stems: _ Ren, 9th Stem, is Yang _ Gui, 10th Stem, is Yin. In the present case, _ Ren represents the concentraion of energy, that is to say, the movement of Yang going toward Yin (concentration), _ Gui represents the manifestation of the energy, that is to say, the movement of Yin going toward Yang (manifestation). These two terms are envisioned here therefore in their dynamic aspect (the same as had been with√ Jia and Yi, 1st and 2nd Terrestrial Branches). According to Qi Bo, Celestial Gui is innate. It is reinforced a posteriori by dietary Jing. This latter is none other than the “sapors”. They first reach the spleen, then are directly conducted to the corresponding organs. When there is too much Jing within the organs, the kidneys absorb it in order to distribute it throughout

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the entire body. The Jing conserved within the kidneys will reach the heart (kidney and heart = Shaoyin) where it will be transformed into blood. This blood will be directed into the 2 curious channels Chongmai and Renmai (CV) to nourish the flesh and make the head and body hair push out√. This is why, in boys, at the time when the biologic energy is powerful, Celestial Gui becomes transformed into blood and reaches the Chongmai and Renmai (CV) which ends up at the chin and lips, hence beard and moustache. In contrast, in girls, when the Celestial Gui arrives, menses appears. In summary, Celestial Gui designates both Jing (energetic quintessence) and blood and not just menses as was supprted by the celebrated Wang Bing (762 A.D.). The thesis of Wang Bing did not then agree with the thesis of the Huangdi Neijing Suwen: “Menses and sperm are the manifestations of Celestial Gui.” The energy of the kidney is therefore both innate (Ren and Gui) and acquired (dietary Jing: 5 sapors). In infants, it goes to spread first within the most essential regions of this age group to assure growth and development: bones and marrow (kidney), muscles and blood (liver). • At puberty, the energy is always prosperous (innate and acquired). The need is less great to furnish growth factors as a priority. One part of this energy then affects the genital organs and curious channels on which they depend. At the time of andropause and menopause, the innate energy sees its potential diminish. The shift is then progressively assured by the acquired energy of dietary origin. The key point is then maintaining life. The energetic potential, being limited, is distributed within the vital sectors to the detriment of others, in particular genital. In this manner, in the Oriental spirit, Gui designates at the same time the Celestial Stems, its maintenance and manifestations. 247.

The same author concludes: “• Bao Chong (uterus) is the site of reunion of the a priori energy of the kidney and a posterior blood coming from the stomach. • On the one hand, the Chongmai conducts the a priori energy of the kidney toward the top in order to place it in relationship with the stomach, and, on the other hand, conducts the a posteriorYin-Blood toward the bottom so that it may pour out into the Bao Chong. As a result, the role of the Chongmai consists of bringing the energy toward the top and conducting the blood toward the bottom in the goal of establishing the realtionship between the kidney and stomach. • The Chongmai is the conductive route of the energy. This energy manifests at Dan Dian (subumbilical region) whose route of exit is found at Qijie (other name for Qichong- St 30). At this level, the energy reaches the side of the umbilicus where the point Huangshu (Ki 16) is found and arrives at the point Tonggu (Ki 20) where it spreads into the middle of the thorax and circulates at the level of the pleura (pulmonary); then it ascends again toward the neck and reaches the laryngeal organ to become exteriorized. This intrathoracic trajectory is the genuine path of the Chongmai. The Chongmai governs the energy, It is therefore different from the Renmai (CV) which governs the blood.”

PARAGRAPH 5 Huangdi: “In some individuals, disturbances of the genital organ causes an exhaustion of sexual energy with inability to have an erection preventing any acts of mating. Despite these states, their beard and moustaches are always flourishing... . How is

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that? In contrast, in eunuchs, beard and moustache fall out after castration... . I would like to understand the cause.” Qi Bo:

“ C a s t r a t i o n signifes ablation of Tong Jin (reunion of pelvic muscles: Mons Veneris) ( 2 ) , which injures the Chongmai and Renmai (CV) and forces the blood to accumulate within the epidermo-dermal system. The Chongmai and Renmai (CV) can no longer bring the blood toward the mouth and lips, hence falling out of beard and moustache.”

EXPLANATIONS AND COMMENTARIES

248.

I - Ma Shi explains:

“Injury to the genital organs without affecting the testicles does not prevent the Chongmai and Renmai (CV) from bringing blood toward the mouth and lips. But it hinders erection. Castration (ablation of the testicles) which injures these 2 curious channels is the cause of the absence of beard and moustache.” II - N.V.N.: In relation to the Bao Chong (Envelope of the Center: Uterus), Zhang Jing Yue furnishes us with the following explanations: 2. Here, “Tong Jin” designates testicles.

“Castration (ablation of the testicles) and the tying off of the clitoris was commonly practiced in ancient China. Sexuality was also an essential problem of the social life of the time. One attached much importance to the genitals (penis and vagina) which came to be the object of careful concern/√attentive care and to be concealed because, according to the Orientals, they are the sites of “distribution” of life. In the past, rich and poor called “Gong” their dwelling. From Xin (219 A.D.), this word “Gong” was reserved only for the designation of the royal palce where only the king (man, masculine sex) could enter and leave. At the time of the Han Dynasty (206-219 A.D.), the Neijing (Suwen and Lingshu), based on this doctrine transmitted from century to century, had been named “Bao Chong” (Envelope of the Center) or “Si Gong” (Fetal Palace), the site where man can penetrate.” In our time, this subject involves pursuit√la recherche both from the physiologic as well as pathologic points of view in womem.

PARAGRAPH 6 Huangdi: “There are individuals born “emasculinated” (Tian Huan) neither ressembling castration nor women whose menses is monthly. Nevertheless,

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their

beard and moustache are absent. What is the cause?” Qi Bo:

249.

“This is due to the insufficiency of Tian Qi (Celestial Energy; a priori e n e r g y ) . The Renmai (CV) and Chongmai are not developed and the Tian Jin (reunion of pelvic muscles: external genital organs) is poorly formed. The energy there is sufficient, but blood insufficient; the mouth and lips are poorly nourished, hence absence of beard and moustache.”

EXPLANATIONS AND COMMENTARIES Ma Shi explains:

“ “Tian Huan” designates male individuals deprived of reproductive organs (emasculinated) or endowed with stunted (atrophied) “Tian Yin (anterior Yin: genital organ) lacking in any viril character, hence without sexual function.”

PARAGRAPH 7 Huangdi: “Correct! The Sage knows perfectly the 10,000 beings and things, like the radiance of the sun, moonlight and the carrying distance of sound (musical). And by listening, he masters the body. Only the Sage achieves elucidation of the Jing Qi (energetic quintessence) of beings and things. In effect, the sage observes: _ the red-yellow color to determine the excessive state of the “heat” energy (of the body), _ the green-white color to evaluate the insufficient state of the “heat” energy (of the body). _ the beauty of the eyebrows to estimate the state of profusion of blood within the Taiyang (SI and Bl), _ the beauty of the beard to appreciate the state of abundance of blood within the Yangming (LI and St). It is a matter of phenomena that take place with time.”

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains:

“This paragraph speaks on Ren Dao (Human Dao)as a function of Tuan Dao (Celestial Dao).

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Green, red, yellow, white and black are the 5 Colors responding to Wu Yin (5 Sounds) and to Wu Xing (5 Movements). _ Red governs summer and yellow, end of summer. As a result, the red-yellow color is the indicator of the excessive state of the “heat” energy which is only Yang energy (of the body). _ Green governs spring and white, autumn. As a result, the green-white color is the sign revealing the insufficient state of the “heat” energy (of the body). 250. _ Black governs winter and responds to Water, place of the Yang energy concealed (deep). As a result, the blackisn color is the sign heralding the excessive state of blood and the insuficient state of the energy (3). _ The 3 Yin and 3 Yang manifest at the time when the energy of Heaven joins together with that of the 5 Seasons. • • • • • •

The first energy (primary energy) is associated with “Jueyin-Wind-Wood”. The second energy, with “Shaoyin-Ministerial Fire”. The third energy, with “Shaoyang-Ministerial Fire”. The fourth energy, with “Taiyin-Humidity-Earth”. The fifth energy, with “Yangming-Dryness-Metal”. The energy of the center (Chong Qi), with “Taiyang-Cold-Water”.

Therefore, Heaven has its 6 seasons and man also has his 6 seasons. In summary, this paragraph speaks on the human energetic to the celestial principle (Tian Dao), in particular to the seasonal energies. In the human body, this energy is distributed at the level of the feet and hands... .” 3. For example, Raynaud’s disease.

PARAGRAPH 8 “In man, the “normal _ _ _ _ _ _

numbers” of blood and energy are:

Taiyang (SI + Bl) has more blood than energy. Shaoyang (SJ + GB) has more energy than blood. Yangming (LI + St) has much blood and energy. Jueyin (XB + Li) has more energy than blood. Shaoyin (He + Ki) has more blood than energy. Taiyin (Lu + Sp) has more blood than energy.

These phenomena are normal and respond to the “ N u m b e r ” of Heaven.”

EXPLANATIONS AND COMMENTARIES

251.

I - Ma Shi explains:

“This paragraph speaks on the “Normal Numbers” of the human being responding to the “Normal Numbers” of Heaven. The Earth is endowed with “5 Movements” and Heaven, “6 Energies”. The combination of 5 and 6 give a period of 5 X 6 = 30 years and a cycle of 30 X 2 = 60 years. Man is endowed also with 5 Movements and 6 Energies in order to respond to Heaven and Earth. This is why, _ the start of this chapter speaks on the 5 Movements of Earth associated with the form (biotype) of the human being,

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_ and the end, on the 6 Energies of man associated with the 6 Energies of Heaven. • At Heaven, it is the Energy, and at Earth, the Form. Man receives the 5 Movements in order to take up a form (biotype), but he always conserves his “root” with the 6 Energies of Heaven, hence the significance of this latter paragraph.” II - N.V.N.: This paragraph speaks on the potential of the blood and energy of the 3 Yin and 3 Yang (Taiyin, Shaoyin and Jueyin; Taiyang, Shaoyang and Yangming) which is an indispensible component in the application of the techniques of tonification and dispersion. Nevertheless, note that these quantitative blood and energetic states cited in this paragraph are not always in accord with Chapter 24 of the Suwen. In effect: • In relation to the Taiyin, we read: “_ more blood than energy” (Lingshu, Chapter 65: “The 5 Musical Notes and 5 Sapors”), “_ more energy than blood” (Suwen, Chapter 24: “Energy and Blood, Body and Mind”) • and in relation to the Jueyin, we read: “_ more energy than blood” (Lingshu, Chapter 65), “_ more blood than energy” (Suwen, Chapter 24). Do these two classics teach contradictory information or is it a question of errors of transcription? Here is the response of Zhang Jing Yue: “The 4 words: “Blood and Energy, Excess and Insufficiency” easily become confused. It is a matter here of an error on the part of transcriptionists. The notions cited in Chapter 24 of the Suwen are correct.” no 252/253.

BOOK VIII Book VIII consists of 10 chapters:

Chapter 66: Origin of the “100 Diseases” (Ba Bing Shui Sheng) Chapter 67: Practice of Acupuncture (Xing Zhen) Chapter 68: Above the Diaphragm (Shang Ge) Chapter 69: Panic and Fit of Rage (Yu Sue Wo Ren)

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Chapter 70: Cold-Heat (Han Re) Chapter 71: Perverse Guest (Xie Ke) Chapter 72: Celestial Relationships (Zhong Tian) Chapter 73: Ability in the Practice of Acupuncture (Guan Tian)

254.

Chapter 74: Dissertation on Diseases and Examination of the Skin of the Forearm (Lun Xi Zhan Chi) Chapter 75: Effects of Needling on Source Energy and Perverse Energy (Ci Jie Zhen Xie) 255.

CHAPTER LXVI Origin of the “100 Diseases” (Ba Bing Shui Sheng)

Chapter 66 of the Lingshu speaks on the origin of the “100 Diseases” placed strictly within the exogenous sphere (6 perverse energies: Wind, Cold, Heat...) and within the endogenous sphere (7 feelings: anger, sadness...). The localization of the disease is differentiated into Yin and Yang and into 3 zones (at the top, at the middle and at the bottom).

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The triggering process of pain (dermalgia, arthralgia, lumbalgia..) and hemorrhoids (nasal, intestinal, gastric...) is also addressed. The formation of Ji Qi (energetic accumulation) is clearly explained. The principles of therapeutic perfection are also clearly specified. The subject of this chapter concerning the causes of diseases explains the title: “Origin of the 100 Diseases” . This chapter consists of 7 paragraphs.

PARAGRAPH 1 Huangdi: “At their start, the “100 Diseases” all originate: _ from the receptivity of the wind, cold, pure humidity... _ or from reactive phenomena of feelings such as joy, anger... . Joy, anger..., in an excessive state, injure the organs; wind, rain... injure the top of the body, and pure humidity, the bottom. The energetic activity of these regions (top, intermediary, bottom) is different. I would like to know the causes of their perturbation.” 256.

Qi Bo:

“The energy belonging to these 3 regions of the body is not of the same potential; it starts either at Yin or at Yang. Allow me to explain to you in detail. When joy, anger... are not brought under control, they injure the organs and disease manifests within Yin (interior). When pure humidity, due to emptiness (of the energy of the body), infiltrates into Yang (exterior), disease manifests within the bottom (of the body). When wind, rain... penetrate with the organism, during emptiness (of the energy of the body), disease manifests within the top (of the body). Thes 3 regions (top, intermediary, bottom) are the sites of manifestation of the 100 Diseases. When perverse energy penetrates deeply into the body, it evolves

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and provokes a multitude of different syndromes that are difficult to enumerate.”

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains:

“At their start, the “100 Diseases” all originate from upset due to bad weather or internal perturbation. Excessive joy and anger disturb the Chi (will: kidney), and disturbances of Chi injure the organs. As a result, the disease starts at Yin. During penetration of pure humidity into the Yang part (of the body), the disease manifests within the bottom, and during penetration of wind and rain into the Yang part (of the body), the disease manifests within the top. At their start, diseases arise only within these 3 regions (top, intermediary, bottom), and during their evolution, the complications are incalculable.”

II - N.V.N.: Zhang Jing Yue (1563-1640 A.D.) furnishes similar explanations: “At their start, the 100 Diseases are only provoked by the attatck of perverse energy and psychoaffective disturbances as distributed in 3 zones: top, intermediary and bottom. Excessive anger and joy cause disturbances at the level of Wu Chi (5 wills) which, in turn, injure the organs. Therefore these diseases start at the Yin. During infiltration of “Pure Humidity” at the time of emptiness (weakness) of the body, perverse Yin is still found at the exterior. As a result, the disease manifests within the lower part of the body. During penetration of “Wind/Rain” energy within the body in a state of emptiness, perverse Yang is found at the exterior. As a result, the disease manifests within the upper part of the body. 257.

At the starting phase, the 100 Diseases are only located within one of these 3 zones. In the evolutive phase, they become transformed into numerous syndromes, difficult to name entirely.”

PARAGRAPH 2 Huangdi: “I still have not grapsed very clearly the process of formation of the disease. I speak to you about this so that you to give me clarification.” Qi Bo:

“Generally, if wind and rain, cold and heat, do not affect an individual in a state of emptiness (of the energy), isolated perverse energy can not be an injurous factor to the health of man. Therefore, numerous are the individuals who, despite great wind or heavy rain, do not become ill because their vital energy is not insufficient. In other words, disease essentially results from “wind” energy playing the role of “perverse emptiness” (Xu Xie) (1) and affects the individual whose vital energy is in a state of emptiness. It is at this time of union of these “2 emptinesses” that the disease becomes triggered. When seasonal (climatic) energy is normal and the constitution of the

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individual robust, one designates them by the name “2 fullnesses. ” In these case, the skin and flesh of the individual are firm and prevent the perverse energy from infiltrating into the body and creating illness. Diseases caused by Xu Xie (perverse emptiness) all originate from disordered energy of the 4 seasons and from the state of weakness of the energy of the body, that is to say, from the fullness of perverse energy and emptiness of vital energy. These are relatively serious. Once within the body, perverse energy has a specific localization, and, according to the site of penetration, this localiztion has a specific name: upper zone, intermediary zone and lower zone, external or internal zone. In short, one groups them into 3 zones.”

1. Name given to disordered seasonal energy.

EXPLANATIONS AND COMMENTARIES Ma Shi explains: “”Wind-Emptiness” (Xu Feng) (2) is a causal factor of the disease, and “Wind-Fullness” (Si Feng) is a factor of the creation and growth of the thousand beings. 258. If the energy of man not in emptiness encounters Wind-Emptiness, disease cannot be produced. As a result, disease manifests in man who encounters Wind-Emptiness when his energy is already in a state of emptiness. The union of these “2 emptinesses” is the essential triggering factor of disease. Similarly, if Heaven is fitted with Wind-Emptiness and man posesses his Energy-Fullness, the union of these 2 fullnesses can not create disease. • The localization of the disease is divided into 3 zones: _ during infiltration of “Perverse Empitness”, the disease localizes at the exterior, _ during accumulation of the energy, the disease localizes in the interior _ and during sexual excess, the disease localizes within Yin, etc.”

PARAGRAPH 3 “This is why, when “Perverse Emptiness” (Xu Xie) attacks man, it localizes first at the skin which becomes slack and and relaxed. The laxity of the skin if followed by the opening of Cou Li (junctions located between the skin and muscles where the sweat gland system is found) favoring the penetration of perverse enrgy via the hairs. Progressively, this penetration goes deep, and during deep penetration, the hairs rise up (piloerection) and cause shivering. This is why the skin is painful (cutaneous pain). • If the perverse energy is not evacuated, it lodges within the Luomai (secondary vessels) and provokes pain of the flesh (dermalgia). • If the pain manifests in intermittent fashion, the penetration id deeper still and the Jingmai (principal channels) follow the Luomai in receiving the perverse energy. When

212

the

perverse energy remains

within

the

Jingmai, it

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causes

shivering

followed by fear and anxiety. If it is not evacuated from the Jingmai, it passes to the Shu points, in this way preventing the energy of the 6 channels (3 Yin and 3 Yang) from reaching the 4 limbs, hence joint pains and lumbar stiffness. • If it persists in the Jingmai, it progresses still deeper and reaches Fu Chong ( 3 ) which causes heaviness and pain of the entire body and 4 limbs. • If it persists within Fu Chong, it evolves toward the stomach and intestines which provokes a gathering of “Water” energy (Shui Qi) characterized by gurgling and abdominal bloating. 2. Disordered wind. 3. This designates the internal vessel og the Chongmai- see explanation on page 224. other? V. II?

• If the “Cold” energy (Han Qi) is excessive, it causes boborygmi and diarrhea stool containing undigested food. • If the “Heat” energy (Re Qi) is excessive, it causes difficult defecation and dysentery (bloody, purulent stools). • If it persists in the stomach, it accumulates outside the these viscera, at the level of Ma Yuan (adipose membranes) ( 4 ) of the thorax and abdomen and becomes fixed in the blood vessels. In the chronic state, it evolves toward disease of accumulation (Ji). with

In conclusion, during infiltration, perverse energy becomes _ either in the Sunmai or Luomai _ either in the Jingmai or liquid vessels _ either in Fu Chong or Huan Jin (abdominal muscles) (5) _ or in Ma Yuan of the stomach and intestines.

fixed:

The invasion of perverse energy extends throughout the entire body. It is so complex that it is impossible to describe.”

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains:

“This paragraph addresses the process of penetration of perverse Yang into the organism necessarily starting via the exterior. It takes birth at the level of the skin in states of emptiness, that is to say, in states of flaccidity and laxity. Perverse cold injures the Wei (defensive energy) and causes a stagnation of blood and energy, hence cutaneous pain. In other words, the places of penetration of perverse cold are always painful. Therefore, one must carefully examine the vessels laocated at Yin and Yang, superificial or deep, in order to determine the superficial or deep localization of the disease. For diagnosis and treatment, one attaches a great importance to this fact.” II - N.V.N.: Information from Zhang Jing Yue is in agreement: “a - When perverse energy is found at the pilocutaneous system, treatment must be carried out at the exterior. Without treatment, the cold perverse progressively reaches more deeply, that is to say, the Luomai which are more superficial than the Jingmai (principal channels), which provokes pains of the flesh (dermalgia). 260.

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b. The Luomai course through the flesh and the Jingmai are concealed in the depths. When the perverse cold leaves the Luomai to reach the Jingmai, it provokes shivering. The Jingmai are linked with the organs. As a result, when perverse cold occurs at the Jingmai, it causes fear. c. The energetic points (Shu: moving points or energetic sites) are sites of concentration of energy circulating within the Jingmai and are localized within the “valleys and small valleys” (Gi Gu: dermal grooves) and at the level of the joints. 4. According to Zhang Shi, this designates the memebranes covering the stomach and intestines. 5. This designates the abdominal muscles.

d. When the perverse energy reaches the Jingmai, the 6 channels (3 Yin and 3 Yang) are obstructed, hence pain and rigidity of the 4 limbs.” In relation to “Perverse Emptiness” (Xu Xie), Chapter 77 of this classic (“9 Palaces8 Winds”) is interesting to consult. The process of penetration of perverse energy and formation of the “Ji” (accumulation) syndrome can be diagrammed in the following way:

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Different phases of penetration of perverse energy and formation of the “Ji” syndrome

PARAGRAPH

4

261.

Huangdi: “I would like you to inform me in a general fashion about the origin of diseases.” Qi Bo:

“Perverse energy infiltrates within numerous little Luo vessels, that is to say, the Sunluo (little blood capillaries), to cause the “Ji” (accumulation) syndrome. This energetic mass is mobile; it goes and comes, ascend and descends... . it is impossible to stop it because it accumulates in the Sunluo of the arms, supple and thin/√ light region of the body. This is why it becopmes progressively displaced toward the gastrointestinal space. If it involves “Water” perverse energy, it flows down toward the interior (intestine) emitting gurgling sounds (displacement of water). If it involves “Cold” perverse energy, it causes abdominal bloating and boborygmi (displacement of air). This “Cold” energy always causes constricting phenomena, hence stabbing abdominal pain. • When the perverse energy stops at the Yangming (St), it accumulates around the umbilicus which becomes tense after a meal and lax in the state of hunger. • When the perverse energy accumulates at Huan Jin (abdominal muscles) , it presents in the form of accumulation like that of the Yangming (St) with pain worsened after a meal and calmed by hunger. • When the perverse energy accumulates within Ma Yuan (membranes, p e r i t o n e u m . . . ) , it causes pain radiating toward the exterior to Huan Jin (abdomnal m u s c l e s ) , calmed after a meal and worsened in the state of hunger. • When the perverse energy accumulates within Fu Chong (internal vessel of the Chongmai) , it provokes peristaltic waves within the abdomen on pressure and lifting of the fingers and a current of “heat” energy which descends toward the thighs evoking the image of flowing out of boiling water. • When the perverse energy becomes localized at the energetic vessels at the level of the spinous muscles and vessels located behind the stomach and intestines, the accumulation appears only in the hunger state and disappears after a meal. If one attempts to look for it with the hand, one will not find it.

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262.

• When the perverse energy becomes fixed at the Shu (energetic) points of the Jingmai (principal channels), it causes obstruction preventing the Xin Ye (organic liquid) from circulating, hence drying out and obstruction of the “orifices” (nose, mouth,...). Such are the routes of penetration of perverse energy toward the bottom (deep) and not toward the top (superficial).”

EXPLANATIONS AND COMMENTARIES N.V.N.: In the West, for the first time in 1971, we pointed out the “Fu Chong”, internal vessel of the Chongmai (6). Zhang Jing Yue gives one description: “The internal vessel of the Chongmai, called “Fu Chong (Fu = hidden/√innermost, Chong = Chongmai), follows the vertebral column to reach the top... . It then descends via the path of the Dumai (GV) to connect with the Luo of the Shaoyin (Ki)...; then, it comes out again at Qijie (other name for Qichong- St 30) in order to go into relationship with the inner thigh before penetrating into the popliteal fossa. In order to diagnose the presence of accumulation of perverse energy at the level of Fu Chong, it is necessary to look for peristaltic waves on finger pressure (on the abdomen), waves followed by a sensation of a current of “heat” energy which, upon lifting the fingers, descends toward the inner thigh.” This comment has an obvious impact on the diagnostic and therapeutic plan.

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6. See “Energetic Topography in Chinese Medicine”, Don Bosco Edition, Marseille.

PARAGRAPH 5 Huangdi: “What is the process of triggering of the “Ji”

(accumulation)

disease?”

Qi Bo:

“ Ji Qi (accumulation) is first caused by “cold” energy, then by Jue Ni (contrary afflux) of this cold toward the top.” Huangdi: “What is the process of formation of Ji Qi ? ”

263.

Qi Bo:

“ Contrary Afflux” (Jue Ni) of cold starts at the bottom. It first causes painful stasis of the feet with trouble walking, then a sensation of ice cold legs with disturbance of blood circulation. Stasis of blood vessels causes a progressive ascent of the “cold” energy up to the abdomen, hence bloating with accumulation of frothy and spolieee/despoiled material which, in the chronic state, becomes transformed into Ji Qi (energetic accumulation). • Sometimes, overeating, a disordered life or overwork can injure the Luomai: _ the Yang Luo being disturbed, blood extravasates toward the exterior triggering epistaxis; _ the Yin Luo being disturbed, blood extravasates toward the interior triggering r e c t o r r a g i e ; _ the Luomai of the stomach and intestines being disturbed, blood extravasates toward the exterior provoking gastrointestinal hemorrhage. • If the exterior of the stomach and intestines is affected by “cold” energy, the frothy and spoliees substances and blood enter into conflict constituting a type of adherent stasis which, being inextricable, becomes transformed into Ji Qi (energetic accumulation) . • Sometimes, severe attack of “cold” energy at the time of psychoaffective disturbances (anger, joy...) accentuates the Jue Ni (contrary afflux) which blocks the circulation of the energy of the 6 channels (3 Yin and 3 Yang) and that of the “Wen” (Moderate Heat’ “mild” heat) energy. This blockage causes blood stagnation and becomes transfromed into Ji Qi (energetic accumulation). ”

EXPLANATIONS AND COMMENTARIES N.V.N.: This paragraph demonstrates the principal causes of the formation of”Ji Qi”.

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According to Zhang Jing Yue: “1 - The afflux of cold toward the bottom provokes joint pains with trouble walking. Ice cold legs cause blood and energetic stasis. When the “cold” energy reaches from the top to the abdomen and intestines, it prevents the Yang energy from functioning, hence abdominal bloating and accumulation of frothy and spoliees substances (substances poorly metabolized) which, in the long run, transform into Ji Qi. 264.

2. Digestive disorder or overeating disturb the functions of the stomach and intestines. Frothy and spoliees substances extravasate and mix with the blood transforming into Ji Qi. 3. Overwork and loss of sleep injure the Luomai of the Yin and Yang. These affect the blood in a state of stasis, making possible the combining of this blood with the frothy and spoliees substances and its concentration at the exterior of the stomach and intestines to transform into Ji Qi. In summary, all these phenomena originate from the divergence√ of the mouth and lower abdomen, from overwork and especially from negligence√. Recall that “Yang Luo” designates the Luomai that go from deep to superficial, and “Yin Luo” , the Luomai that go from superficial to deep.

PARAGRAPH 6 Huangdi: “How do diseases of the Yin zone take place?” Qi Bo:

the

“Sadness and preoccupation injure the heart. Attack of cold followed by cold food injures the lung. Coitus in a drunken state and exposure to wind after marked sweating injures spleen. Physical effort (overwork) after coitus or after sweating injures the kidney. Such are the 3 zones (upper, middle and lower) within which diseases occur.”

EXPLANATIONS AND COMMENTAIRES I - Zhang Shi explains:

“The “injured heart” is an illness localizing at the Yang. The “injured lung” is an illness localizing at the Qi (energy). The “injured liver” is an illness localizing at the Xue (blood). The “injured” spleen is an illness localizing at the Ying (nutritive energy) and Wei (defensive energy). The “injured kidney” is an illness localizing at the “Yin root”. 265. In this way, all illnesses injuring the organs occur within the Yin sphere.

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II - N.V.N.: This paragraph speaks on the formation of Ji Qi (energetic accumulation) originating from the association of psychologic components and the “cold” energy (Han Qi). In summary, the formation of Ji Qi is possible when the “cold” energy attacks the exterior (of the organism) at a time of sadness, joy,... injuring the interior. This cold causes an obstruction at the level of the Shu (energetic) points of the 6 channels (3 Yin and 3 Yang) and blocks the circulation of the “Wen” energy (mild energy or moderate heat). It results in a stagnation of Yin-Blood which, in the chronic state, transforms into Ji Qi .

PARAGRAPH 7 Huangdi: “Correct! How do you treat it?” Qi Bo:

“Carefully examine the localization of the pain to determine the reactions of concerned channels. Know clearly the excess and insufficiency before using tonification or dispersion. Do not act against climatic conditions (that is to say, treat the organs as a function of the seasons). In this manner is the treatment adequate.” the

EXPLANATIONS AND COMMENTARIES N.V.N.: Tonification and dispersion are known in the West. But the therapeutic result depends on the technique of needling and especially on the manipulation of the needles. This must obviously be constantly be kept in mind. This is what this short paragraph teaches.

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no 266/267.

CHAPTER

LXVII

Practice of Acupuncture (Xing Zhen)

Chapter 67 of the Lingshu speaks on the different Yin-Yang complexions of the human body. The Yin energy and Yang energy can be in emptiness or fullness. For this reason, during needling, the energy reacts differently from one individual to another. In individuals of the “Chong Yang’ (Superimposed Yang) type, the reaction of the needle is rapid, and in that of the “Chong Yang” type endowed with a part of Yin, the reaction is relatively slow. In individuals whose Yin and Yang are balanced, the energy reacts as soon as the needle is put in, and individuals whose Yin is more abundant than Yang, the reaction only appears after several sessions of acupuncture. The worsening of the disease by misunderstanding the technique of manipulation of the needle on the part of the poor physician is also broached. This chapter then emphasizes the rules of manipulation of the needle during treatment which justifies its title: “Pratice of Acupuncture”. This chapter consists of 3 paragraphs.

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Huangdi; “After having listened to your explanations on the “Rules of the 9 Neeldes”, I have followed them to treat the “100 families”. Nevertheless, the blood and energy of these families are not the same. 1. In some individuals whose Shen Qi (mental energy) is barely affected, the energy arrives immediately at the needle√ √ ? . 2. In others, the energy arrives as soon as the needle is put in. 268.

3. In still others the energy arrives after removal of the needle. 4. In yet others, the energy arrives only after several seesions of acupuncture. 5. In yet others, the energy arrives “in the wrong way” (Ni: indicates aggravation of the disease) as soon as the needle is removed. 6. Finally, in others, the energy arrives “in the wrong way” only after some sessions of acupuncture. These 6 different reactions of the energy are seen in all circumstances. I would like to know the causes.” Qi Bo:

“In individuals of the “Chong Yang” (Superimposed Yang; simultaneous presence of 2 forms of Yang) , the Shen Qi (mental energy) is naturally excitable and the energy (Qi) reacts easily.” Huangdi: “What do you mean by “man of the Chong

Yang type”?”

Qi Bo:

“The Chong Yang type is marked by pasionate/fervent feelings like fire burns vividly√ √ . He has an arrogant/proud temperment. His speech is rapid. He walks with long strides. The energy of the 2 organs, heart and lung, are in excess. The Yang energy circulates abundantly and smoothly and opens toward the “4 Seas”. As a result, his Shen (mental) is naturally excitable and his energy reacts quickly.” which

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains: “In the “Chong Yang” type, the energy of the 3 Yang of the foot and hand, of the left and right sides, and that of the Heart and Lung, are in excess. The heart receives the Shen (mental) and the lung is the “master” of the Qi (energy). When the energy of

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the heart and that of the lung is in excess, the Xin-Shen (Heart-Shen) is impulsive and the Qi (energy) is radiant. This is why the Shen Qi reacts promptly to needling.” II. Ma Shi adds:

“Here, the word “Yang” designates the Wei (defensive) energy.”

PARAGRAPH 2

269.

Huangdi: “Nevertheless, there are “Chong Yang” types whose Shen Qi does not react as quickly. Why?” Qi Bo:

“These

Huangdi: “What

Chong Yang types only possess a little Yin energy in the interior.” are

their

characteristics?”

Qi Bo:

“The type of excess Yang is generally joyous and the type of excess Yin is normally easily angered, but his anger is easily controlled. In our case, the Chong Yang type is endowed with a small amount of Yin energy which impedes the movements of “Separation/Reunion” of Yin and Yang and prevents the Shen Qi from responding rapidly to needling.”

EXPLANATIONS AND COMMENTARIES Zhang Shi explains:

“Clear-sightedness and cheerfulness are two qualities belonging to Yang. Stagnation and suffocation are two qualities belonging to Yin. As a result, that which possesses more Yang is generally joyous and that which possesses more Yin is usually easily angered. Frequently being easily angered is due to the presence of a small quantity of Yin within Yang; but it is easily “cooled down” (brought under control) by the Yang. Therefore, to speak of “Yin within Yang” is to speak of damage caused by Yin that the Yang cannot avoid√?.The movements of “Separation/Reunion” (of Yin and Yang) are then impeded. This is why the Shen Qi cannot respond rapidly to needling.”

PARAGRAPH 3

270.

Huangdi:

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“In

certain

individuals,

the

energy

responds

immediately

to

needling.

Why?”

Qi Bo:

“In them, Yin and Yang are balanced, blood and energy are fluid and freeflowing. This is why the energy reacts spontaneously to needling.” Huangdi: “In certain individuals, the energy only reacts after removal of the needle. Which energy is responsible for this reaction?” Qi Bo:

“In these individuals, the Yin energy is in excess and the Yang energy is in insufficiency. In the excessive state, Yin (deep) attracts Yang (superficial) in order to bury it/ s e l f √ √ deeply. This is why the energy reacts late, after removal of the needle.” Huangdi: “Sometimes the energy only reacts after several acupuncture sessions. What is the energy responsible for this late reaction?” Qi Bo:

“It is a question of individuals whose Yin is in excess and Yang is in insufficiency. Their energy is concealed within the interior; the reaction is then difficult to produce. This is why it necessitates several acupuncture sessions for it to appear.” Huangdi: “Sometimes, contrary reactions take place after needling. What is the energy responsible for this reaction?” Qi Bo:

“The contrary reaction and the aggravation of the disease after acupuncture neither originate from the Yin energy and Yang energy, nor from their superficial or deep state. The poor physician is responsible and not the Xing Qi (form/energy).” EXPLANATIONS AND COMMENTARIES Ma Shi explains:

“Contrary reactions during implantation of the needle and worsening of the disease after needling do not originate from the superficial or deep state of the Yin and Yang energy. The only result from ignorance of the circulation of Ying (Rong, nutritive) energy and Wei (defensive) energy. 271.

The Ying energy circulates deeply, within the channels, and the Wei superficially, outside the channels. As a result, _ to summon the Wei energy, the needling must be superficial _ and to summon the Ying energy, the needling must be deep. The contrary reacttion therefore originates from the depth of implantation of the needles:

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_ deep needling instead of superficial needling _ superficial needling instead of deep needling. As a result, the acupuncturist must understand well the forms (types) of energy in order to transmit to the needle the proper depth.”

no 272/273.

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CHAPTER

LXVIII

Above the Diaphragm (Shang Ge)

Chapter 68 of the Lingshu speaks on the diaphragmatic syndromes grouped into: _ Shang Ge (supra-diaphragmatic) syndromes and _ Xia Ge (sub-diaphragmatic) syndromes. The first is characterized by spontaneous vomiting after a meal. and the second, by late vomiting, 24 hours after a meal. The Shang Ge syndrome is a common ailment. This is why the term “Shang Ge” (“Above the Diaphragm”) had been chosen as the title of this chapter. This chapter consists of 3 paragraphs.

PARAGRAPH 1 Huangdi: "Shang Ge” (supra-diaphragmatic) syndrome, caused by the accumulation of the energy, is characterized by post-prandial vomiting. I know this. In contrast, in “Xia Ge” (sub-diaphragmatic) syndrome, due to the presence of worms (tapeworms, earthworms...), vomiting only occurs 24 hours (circadian cycle) after a meal. I still have not clearly understood its etiologic process. I would like you to explain it to me in detail.” EXPLANATIONS AND COMMENTARIES

274.

I - Ma Shi explains:

“The word “Ge” means diaphragm. Here, the supra- and sub-diaphragmatic syndromes are not provokes by the muscle itself. Instead, one takes the diaphragm as reference point to individualize the supra-diaprhagmatic syndrome of energetic origin and the sub-diaphragmatic syndrome or parasitic origin.

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However, in our times, some brothers confused the “Guan Ge” (barrier-separation) syndrome cited in pulsology and the “Ge” (diaphragmatic) syndrome. Also, they are totally ignorant of the diseases caused by the energy and diseases caused by worms. What a pity! The diaphragm is attached in front to the region of Juiwei (CV 15) and behind it inserts at the level of the 11th dorsal vertebra. It is a muscle separating the thorax from the abdomen which has the role of preventing the impure energy from rising up toward the top and “soiling” the lung and heart. In this paragraph, the sub-diaphragmatic syndrome of “parasitic” origin is more detailed than the supradiaphragmatic syndrome of “energetic” origin.” II - N.V.N.: Information from Zhang Jing Yue is worthwhile: “When the energy of the stomach is affected, the energy of the intestines is damaged and “cooled down”, and the plundered/strippedspoliee “cold” substance flows out toward the ntestines. Intestinal worms, subjected to the cold, no longer move about and accumulate within the region of Xia Wen (duodenum). Here, the Wei (defensive) energy designates the energy of the spleen. When it can no longer circulate, perverse energy accumulates in this region.”

PARAGRAPH 2 Qi Bo:

“Uncontrolled joy and anger, digestive disturbance and unstable cold and heat injure the energy of the stomach and favor the outflow of p l u n d e r e d / s t r i p p e d s p o l i e e (dietary) cold toward the intestines. This perverse cold hampers the movements of worms (earthworms, tapeworms...) and requires them to collect in the region of Xia Wen (duodenum) hence: _ fullness of energy of the stomach and intestines _ blockage of the circulation of Wei (defensive) energy _ easy settling of worms in this region. 275. • At the time of a meal, intestinal worms ascend in search of food which also aggravates the emptiness of the region of Xia Wen and favors the concentration of perverse cold in the form of Ji Ju (Accumulation/ Gathering) which becomes transformed into Nei Yung (internal abcess). • Once formed, Nei Yung provokes painful tractions of the region of Xia Wen (duodenum). _ In the case where Nei Yung is located in the interior of Xia Wen, the pains are deep and can only be perceived on palpation. _ In the case where Nei Yung is located at the exterior of Xia Wen, the pains are superficial and the skin (of this region) is “burning”.”

EXPLANATIONS AND COMMENTARIES N.V.N.:

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According to Zhang Jing Yue: “When worms are subjected to cold and perceive food odors, they are driven to ascend to look for nourishment. When the worms reach the top and allow √their place in the perverse cold, they rapidly gather within Xia Wen and are transformed into “Nei Yung” (internal abscess) and impede digestive movements, hence late vomiting arising only at the end of the circadian cycle (24 hours after a meal). Generally, perverse cold is latent either in the interior or at the exterior of Xia Wen. This is why the “heat” (inflammatory--> pain) energy sometimes manifests deeply within the abdomen, sometimes superficially at the epidermo-dermal region.”

PARAGRAPH 3 Huangdi: “What

is

the

treatment?”

Qi Bo:

“Exert slight pressure on the spot where Nei Yung (internal abscess) is found determine the direction (of shifting) of the “inflammatory” energy. _ First apply a superficial stick near the abscess, then progressively orient the needle deeper. _ Repeat the needling. Do not exceed 3 punctures. 276. to

of Nei

The key point is needling as a function of the deep or superficial localization Yung: _ when it is superficial, nedling must be superficial, _ when it is deep, needling must be deep.

• It is advised to add warm applications to the needled area with the goal of introducing warm air to the interior to reduce the virulence of the perverse energy. A large abscess, as a result, will supperate. • Then it is necessary to: _ know how to associate the therapeutic methods with hygenic and medical means, _ respect the “prohibitions” to supress the toxic energy in the interior. Also, to live with serenity and calm, not against the “natural world” is to aid the energy of the interior to circulate harmoniously. It is only instead by the latter that one prescribes salty and bitter flavor to eliminate the abscess (pus) via the digestive (anal) route.”

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains:

“1. “... determine the direction of the inflammatory energy”, is to follow the Wei (defensive) energy according to the circulation of Zu and Shou Yangming (St and LI) to choose the points to needle.

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2. “Do not exceed 3 punctures” implies that: _ in the first place, superficial needling chases away the perverse Yang energy _ in the second place, deep needling evacuates the perverse Yin energy _ and finally, needling deeper still makes the cereal energy return, that is to say, the essential or vital energy, produced by the Shui Gu (Water-Cereals). If one needles three times in this manner, the cereal energy will escape... . 3. “To live with serenity and calm...”. Of these words from Chapter 1 of the Suwen (“Ancient Celestial Origin”), Qi Bo specifies: “The Sages of the ancient era recommended to avoid the energy and perverse wind and to always have the heart in a state of “serenity and nothingness” so that the Jing energy (quintessence) remains harmonious and the Shen (mental) remains strong in the interior. As a result, how could the disease survive? 277.

Therefore, ancient men have a calm mind and little passion. They are tranquil and never doubt. Their bodies can be fatigued but moderately so. Their Jing energy is harmonious. They are satisifed with their food and type of clothes. the men of this era were of peaceful ways. They lived in harmony, one with the other, without jealousy or envy. they were called “Fa” (simple and sincere). No obscene words troubled their hearts, no desire tired their eyes. Ignorant or learned, wise or not, they had no fears of external phenomena... . Always in harmony with the Dao of Eugenism, they could live to one hundred years without their healkth being diminished. This was due to “perfect virtue”.”

II - N.V.N.: The true principles in order to observe the “nothingness” of Lao Tsu, explaining the exact sense of the term “serenity and nothingness” used by Qi Bo, are the following: “In the interior, examine the heart; the heart no longer has anything of the heart. At the exterior, examine the appearance; the appearance no longer has anything of the appearance. Outside, examine the beings; the beings are no longer beings... . Therefore, one only perceives that there is only nothingness.

“Then, in examining nothingness, one only finds nothingness. If there is no nothingness, there remains only nothingness. Nothingness is already nothing; nothing from nothing is also nothing; nothing from nothing is still nothing. “Transparency is in general calm. If the calm is no longer calm, how will desire arise? Desire not arising is true repose. “Truth usually corrsponds to beings. Truth usually contains Jing, often in motion, often at rest. rest is then called “true rest”.” This text translates the state of mind of the sage who, after a long progression succedds in “leaving himself” to rejoin the Essential Unity and becomes aware of the precariousness of manifesting. He then clearly understand/conceives√ the notion of “Nothingness” and, as a result, acquires serenity. • The prescription of salty and bitter flavor is mentioned because: _ salty flavor follows the transformation of Water and possesses two properties: solidification and liquifaction, _ bitter flavor follows the transformation of Fire and can heat up the stomach. Therefore, association of these two flavors has the purpose of activating digestion and stopping vomiting.

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CHAPTER LXIX Panic and Fit of Rage: Aphonia 229

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(Yu Que Wu Ren)

Chapter 69 of the Lingshu speaks on the pathologic process of aphonia and emphasizes the importance of the epiglottis, uvula, larynx, lips, mouth and hyoid in utterance. The thickness and size of the epiglottis affects the tonality of sound. When “cold” energy becomes localized at the epiglottis, it hinders the movements of opening and closing, hence aphonia. Treatment consists of dispersing the blood Luo located at the Zu Shaoyin (Ki) and Chongmai, as well as the point Tiantu (CV 22). The basic causes of aphonia are of psychoaffective origin. such as panic, fit of rage... . This is why this chapter is entitled “Panic and Fit of Rage: Aphonia”. This chapter contains 2 paragraphs.

PARAGRAPH 1 Huangdi questions Shao Shi: “Panic and fit of rage can cause sudden extinction of the voice. This originates from the obstruction of which energetic route? Or what is the type of energy which ceases to circulate in order to hinder the emission of sounds? I want you to explain the basis of the therapeutic goals to me.” 280.

Shao

230

Shi relies: “The pharynx (Ye Hou) is the path of “Shui Gu” (Water Cereals). The larynx (Hou Lung) is the path of ascent and descent of the energy. The epiglottis (Hui Yan) is the door of emission of sounds. The lips and mouth are shutters of the door of sounds. The uvula (Xuan Yung) is the “border town√ door of sounds”. The naso-pharynx (Hang Zang) is the limit of entry and exit of the energy. The hyoid (Huang Gu) , governed by the Shen Qi (mental energy), commands

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the function of the tongue and the emission of sounds. • This is why continuous rhinorrhea originates from the obstruction of the nasal fossa impeding the area of distribution of the energy (air). If the epiglottis is small and thin, the path of exit is rapid, opening and closing flow easily and the path of entry of the energy is easy. If the epiglottis is large and thick, opening and closing are difficult and the path of entry and exit is slow, hence stuttering (Chong Yon). • Sudden aphonia is due to the fixation of perverse cold at the level of the epiglottis. It loses its function of emission of sounds. Similarly, if there are sounds, these sounds are not from the voice, hence aphonia.”

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains:

“1. The neck of the human being is endowed with two ducts: a pliable duct and a firm duct. The pliable duct is located at the anterior part and bears the name “Ye Hou” (pharynx). It is the path of entry of the Shui Gu (Water Cereals). It communicates with the 6 bowels. The firm duct, situated at the posterior part, is named “Hou Lung” (larynx). It is the path of entry and exit of the Celestial energy (air). It communicates with the 5 organs. 281. Also, in Chapter 29 of the Suwen (“Study on Taiyin and Yangming”), we read: “Hou Lung (larynx) responds to the energy of Heaven (respiration), and Ye Hou (phraynx), to the energy of Earth (swallowing). Also, Yang is easily attacked by Wind (Heaven) and Yin by Humidity (Earth).”

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Figure 1: Energetic vessels at the level of the buccal and laryngeal cavities.

2. Hui Yan (epiglottis) is a cartilaginous strip of triangular shape which juts into the glottis. it closes the larynx at the time of swallowing and opens the larynx during respiration and speaking. This is why one names it “door of emission of sounds”. It corresponds to the lung. 3. Xuan Yung (uvula), generally called “tongue”√, designates the fleshy and elongated median projection of the nasal part of the pharynx. During swallowing, it separates the pharynx(path of Shui Gu- Water Cereals) from the larynx (respiratory path). This is why on calls it “barrier” (flap of the great door separating these 2 regions). 282. 4. Hang Zang (naso-pharynx) is situated above the laryngo-pharyngeal organs and at the posterior part of the nasal cavity. The energy (inspired air) and the liquid substance of the mouth and nose communicate at this level. 5. Huan Gu (hyoid), midline bone in the shape of a horseshoe, is located at the upper part of the laryngopharyngeal system. Below, it has a relationship with the “Heart-Lung” system. his is why on names it “ambassador” of the Shen Qi (mental energy). It also has a relationship with the base of the tongue. Therefore, it controls lingual movements. 6. The naso-pharyngeal orifice is closed because the energy (pure) does not circulate. In other words, when the energy does not circulate, the liquid components (impure) stagnate and the area of distribution of the energy loses its function. 7. Stuttering (Chong Yon) designates a problem of speech of psycho-motor origin which manifests as staccato repetetions of of a syllabus and involuntary stoppage in the rate of flow of words. These problems are due to the poor functionng of the opening and closing movements of the epiglottis.”

II - N.V.N.: It appears necessary to us to present a diagram localizing the anatomic components and energetic vessels mentioned in this chapter (1).

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PARAGRAPH 2 Huangdi: “How do you needle?” Qi Bo replies: “In ascending, Zu Shaoyin (Ki) _ enters into connection with the base of the tongue _ commnicates with the h y o i d _ and ends at the e p i g l o t t i s . Treatment consists of dispersing the blood at the level of the 2 channels, Zu Shaoyin (Ki) and Renmai (CV), to eliminate the perverse cold. The e p i g l o t t i s contains a vessel linked to the Renmai (CV). As a result, one must needle the point Tiantu (CV 22) in order to recuperate the energy of the epiglottis to assure the emission of sounds.”

1. See Figure 1, page 279, taken from “Atlas of Anatomy”, Midsi edition.

EXPLANATIONS AND COMMENTARIES

283.

I - Zhang Shi explains:

“1. The energetic path of the kidney has 2 branches: _ one branch which reaches the base of the tongue _ and another which connects to the points Lianquan (CV 23) and Yutang (CV 18) to go into realtionship with the Jing Qi (liquid quintessence). Because the Zu Shaoyin (Ki) has the function of reception/conservation of the a priori Jing Qi (innate energetic quintessence), it reaches the top and links up to the “orifices” (nose, mouth...). 2. “...Disperse the blood at the level of the 2 channels, Zu Shaoyin (Ki) and Renmai (CV)” means to say that one must disperse the point of reunion/meeting of these 2 channels, that is to say, the point Tiantu (CV 22).”

II - N.V.N.: 1 - According to Zhang Jing Yue, “...to disperse the blood of the 2 channels, Zu Shaoyin (Ki) and Renmai (CV), is to needle in dispersion the point Taixi (Ki 3) of the Zu Shaoyin (Ki) at the level of the 2 feet (malleoli) because this point is the site where the blood of the vessels flows out”. In summary, the therapy of energetic medicine is not rigid. Whether to apply tonification or dispersion depends on whether the cause of the disease is internal or external. 2 - It is deplorable that some French and German translations of this chapter do not conform at all to the spirit of the original text. The Westernization of Classical Chinese Medicine without completely mastering the true basis of energetic medicine is only an imaginary project.

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CHAPTER LXX Cold-Heat (Han Re)

Chapter 70 of the Lingshu speaks on the etiology, diagnosis and principal therapy of “scrofula” (1)(Lou Li). This affliction is generally accompanied by signs of “cold” (sensation) and “heat” (fever). In this way, the words “Cold-Heat” are taken for the title of this chapter. This chapter contains 2 paragraphs.

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PARAGRAPH 1 Huangdi: “ Scrofulas” (Lou Li) manifest by fever (Re) and fear of cold (Han). In the majority of cases. they are located at the neck and sub-axillary region. Which energy is responsible for this illness?” Qi Bo:

“ Adenitis” (lymphatics).”

(Re

Lou) is due to fixation of “toxic” energy within the vessels

1. Glandular swelling; lymphadenopathy.

Huangdi: “What is the chief therapy of the scrofulas?” Qi Bo:

“The “root” and the “summit”

286.

(Ben) of this disease is found at the level of the internal organ, (Jiao) , at the neck and axilla.

When “ t o x i c ” energy is located within the Jingmai (principal channels) without reaching the “flesh” system to transform into blood and pus, treatment is easy.”

EXPLANATIONS AND COMMENTARIES I - Ma Shi explains: “The term “Lou Li” (scrofula) designates the ganglionic chain extending from above downward and generally localizes at the neck and axilla. Because this ganglionic chain evokes the image of a mousehole, it is given the name “Re Lou”. Because the “toxic energy” (Du Qi) accumulates in the Jingmai (principal channels), the disease drags on indefinitely.

a - This disease has its “root” (Ben) at the level of the organs and its “summit” (Jiao) at the level of the neck and axilla. First, it starts at the Shaoyang (SJ and GB), then reaches the Yangming (LI and St). From there it evolves to the Jueyin (XB and Li) and Taiyin (Lu and Sp). Generally, the disease originates from stagnation of “toxic” energy at the level of the Jingmai (principal channels). As a result, it “root” (Ben) is found at the level of the organs and its “summit” (Jiao) appears at the level of the neck and axilla. b - “Toxic energy” (Du Qi): the generic name serving to designate a type of extremely virulent perverse energy as opposed to the disordered perverse energy of the 4 seasons. Generally, it is a question of toxic wind, toxic heat, toxic cold... , that is to say, infectious and contagious energy able to manifest at any time of the year.”

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II - Zhang Shi states: “1. Lou Li (scrofula) also has the name “Re Lou” (adenitis, lymphadenitis). In the majority of cases, this ailment appears in the post-auricular, cervical or sub-axillary areas associated with 2 channels, Yangming and Shaoyang. It is caused by the fixation of toxic energy within these two channels. At the start, it presents in the form of one or two nodules the size of a grain of wheat whose number progressively increases. In the evolutive phase, it is inflammed and painful, followed by fever (heat) and chills (cold). The skin of the infected area is a pale red color. In this regard, Chapter 74 of this classic (“Dissertation on Diseases and Examination of the Skin of the Forearm”) is consulted to more deeply understand the evolution of this disease. 287.

2. According to our masters of antiquity, scrofulas originate from the absorption of food products saturated with mouse saliva√ (2). This toxic substance (saliva) infiltrates into the 2. In our times, according to some authors, scrofula is the particular form tuberculosis (perhaps even syphilis) takes when it hits young lympphatic individuals.

organs and exteriorizes at the level of the Jingluo (principal and secondary channels) of the neck and axilla to trigger the disease. This is why, long ago, one used cat meat to make up anti-scrofula medicines according to the principles of inhibition (of the law of 5 Movements). 3. Scrofula is an external disease, usually resistant to treatment. Generally, is is of psychoaffective origin (worry/preoccupation, sadness/anger...). The energy of the liver compressed is transformed into “Phlegm-Fire” and accumulates within the Shaoyang and Yangming channels. Then the “muscular” (tendinous Jing) energy condenses and assumes the form of little nodules (ganglia) which connect up one to the other. Mobile on palpation, these ganglia are not adherent to the deep layer; acupuncture and moxabustion are recommended. In contrast, if they are rooted in the flesh, that is to say, immobile, acupuncture and moxabustion are strictly contra-indicated.”

III - N.V.N.: A - Zhang Jing Yue gives us the following definitions: “Lou Li”: generic name designating non-suppurative cervical or axillary adenitis (reactive adenitis). “Re Lou”: generic name designating cervical or axillary adenitis revealing an oozing nature or chronic appearance (scrofula, ecrouelle=scrofula?!...).

One recognizes 9 types of adenitis: 1. “Lou”: adenitis of small size. 2. “Li”: adenitis of large size. 3. “Dan Lou”: adenitis of “phlegm” origin, localizing at the anterior part of the neck. 4. “Shi Lou”: adenitis of “humdity” origin, localizing at the sides of the neck. 5. “Qi Li”: adenitis of energetic origin which becomes swollen after each bout of anger and becomes inflammatory and edematous. 6. “Gan Li”: adenitis of tendino-muscular origin, of firm and contractile nature. 288. 7. “Luo Li”: adenitis which connects up one to the other in the form of a sting of pearls (mousehole). 8. “Re Seng”: adenitis with central fistula not yet firm and other fistulas at the periphery making the form of a “mousesouris”. 9. “Mouse crossing the hole”: cervical or axillary adenitis uncurable upon the appearance of an ulceration on the sole of the foot.

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All these adenitises are resistant and very serious.” B - The problem of “Root” (Ben) and “Summit” (Jiao) has the objective of adapting treatment to the particular disease: _ to etiology or symptomatology _ to seriousness or benignness _ to acute or chronic nature. In general practice, the physician often confronts concrete pathologic situations which can be complex and of infinite diversity. Faced with all these situations, it is important to discern the Root and Summit and study the evolutive process of the disease before making a therapeutic decision. In the Suwen, Chapter 65 (“Study of Summit-Root Following the Evoultion of the Disease”), we read: Huangdi: “The disease has its “root” (Ben) and its “summit” (Jiao) and needling ahs its “contrary” and “favorable” effects. What is the significance of this?” Qi Bo: “During needling, it is necessary to discern the disease belonging to Yin and that belonging to Yang, it acute or chronic nature, before choosing a therapy, either a “contrary” or “favorable” treatment or a treatment of the “root” or “summit”. The key point is to conform with the therapeutic principles of “root” and “summit” according to the pathologic process. It has clearly been stated: Some diseases localizing at the summit are treated at the summit, and some others localizing at the root are treated at the root. In other cases, one treats the summit in disease of the root and the root in disease of the summit. Therapeutically, often treatment of the summit is effective; often treatment of the root gives good results; often orthodox treatment cures the disease; often heterodox treatment curbs pathologic manifestations. In this manner, to know the principles of contrary-favorable is to know how to resolve therapeutic problems; and to know the notion of root-summit is to be able to cure any disease. To fail to recognize these notions is to risks regrettable errors. 289. Despite the limits of a reasoning based on “Root-Summit”, “Contrary-Favorable” and “Yin-Yang”, its utility is of great capacity. It permits foreseeing the seriousness of some diseases, evaluating the extent of the pathologic process from a simple clinical sign and anticipating the development of the disease as soon as it manifests; in other words, judging the depth by observing the surface and discerning the invisible by analysis of the visible. To understand “Root-Summit” is easy, but to practice it is difficult.” This paragraph therefore stresses the importance of the notion “Root-Summit” (Ben-Jiao) and its usually complex application. Zhang Jing Yue emphasizes: “The clinical application of the notion of “Root-Summit” is not simple. It demands a deeper knowledge of what is “contrary” and what is “favorable” in the goal of therapy.”

PARAGRAPH 2 Huangdi: “What is the therapeutic conduct of this disease?” Qi Bo:

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“The therapeutic conduct consists of obeying the principle of “Summit-Root”

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(Jiao Ben) in order to progressively eliminate the cold (chills) and heat (fever) of the disease. The key point is: _ to follow the channels in order to choose the points _ and utilize a suitable acupuncture method, that is to say, the technique of tonification and dispersion, transmitting to the needle slow movements of advancing and retreating in order to disseminate the toxic energy accumulated within the interior (of the body). If the scrofula (Lou Li) is small in size like a grain of wheat, a single session of acupuncture suffices to obtain good results and 3 sessions to assure cure.” Huangdi: “What is the prognosis of life (prosperous) and of death (disastrous) of the disease?” Qi Bo:

“Turn the eyelid over and examine the eye. The presence of little blood capillaries, crossing the pupil, directed from the top downward, is a serious sign because 290. _ in the presence of a single blood vessel crossing the pupil, death follows in 1 year, _ in the presence of 2 blood vessels crossing the pupil, death follows in 2 years, _ in the presence of 3 blood vessesl crossing the pupil, death follows in 3 years. In the absence of these vessels, the disease is relatively easy to treat.”

EXPLANATIONS AND COMMENTARIES Ma Shi explains:

“The eye is the site of reunion of the Jing (quintessence) of the 5 organs and the pupil is formed by the Jing of the bones (kidney). In rising up toward the top (eye), the toxic energy encroaches on the Yin (blood) zone and contaminates the ocular vessels, hence the appearance of little capillaries crossing the pupil. The descent of 2 or 3 vessels crossing the pupil indicates the relatively slow evolution of the disease toward the fatal period (death in 2 or 3 years). In contrast, the descent of a single vessel crossing the pupil is the indicator of a high degree of toxicity of perverse energy and the relatively rapid evolution of the disease (death in 1 year). This is why the fatal evolution of the disease is distinguished into slow or rapid evolution as a function of the number of blood vessels crossing the pupil.”

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Figure 1: Prognosis of seriousness of the disease (scrofula). 291.

CHAPTER LXXI Perverse Guest (Xie Ke)

Chapter 71 of the Lingshu speaks on the fixation of perverse energy within the organism. The theme of the paragraphs are: 1, 2. 3. 4. 5. 6.

Fixation of perverse energy and the cause of insomnia. Correlation between Heaven, Earth and Man. Rules of needling as a function of entering and exiting of the energy within the Jingmai. Absence of points of the Hand Shaoyin (He) and the role of the Xin Bao Luo (XB), Needling techniques: tonification and dispersion, “in opposition” and “in pursuit”. Relationships betwen the “8 Xu” (8 Emptinesses) and the 5 organs.

This chapter contains 6 paragraphs.

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PARAGRAPH 1 Huangdi questions Ba Gao: “ S o m e t i m e s , “ perverse guest” (Xie Ke: perverse energy lodged within the o r g a n i s m ) prevents the individual from closing his eyes and lying down. Which energy is responsible for this problem?” Ba Gao: “Once “Wu Gu” (5 Cereals) are in the stomach, wastes, Xin Ye (metabolized food liquid) and Zong Qi (innate or ancestral energy) circulate following the “3 direct routes” (San Sui): _ Zong Qi (innate energy), conserved in the thorax, reaches the laryngopharyngeal organs, controls the vessels of the heart and establishes the respiratory route. 292. _ Ying Qi (Rong Qi: nutritive energy) , isolated from√ toward the vessels (blood) within which the combination of transforms into Xue (blood) which, at the exterior, maintain interior, are directed into the 5 organs and 6 bowels. This Y i n g energy circulates through the entire body, “ K h r o ” (1) n u m b e r s of the clepsydra.

the Xin Ye, conducts it these two substances the 4 limbs and, in the conforming to the

_ Wei Qi (defensive energy) , nimble and fiery energy, originating from the Cereal-Water (Shui-Gu), circulates first in uninterrupted fashion within the epidermo-dermal space and within the zone of distribution of the flesh ( Fen Ru: space separating the dermis and muscles). During the day, it circulates within the Yang part and at night within the Yin part of the body, generally within the zone belonging to the Foot Shaoyin (Ki) before following the circuit of the 5 organs and 6 bowels. In the event of contrary afflux of perverse energy bcoming fixed within the 5 organs and 6 bowels, Wei Qi (defensive energy) only protects the external part of the body, that is to say, only circulates within the Yang part without penetrating into the Yin part. As Wei Qi only circulates in the Yang part, the Yang energy goes into fullness. When the Yang energy is in fullness, the Yangqiao is in an excessive state and cannot penetrate into the Yin part. Tin is then in emptiness and the eyes can no longer close, hence insomnia.” Huangdi: “How is it treated?”

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1. Unit of measure in the time of the ancient era.

Ba Gao: “Treatment

of

insomnia

consists:

_ of tonifying the Yin part in a state of insufficiency and dispersing the Yang part in a state of excess, _ and of regularizing the energy in a state of emptiness and that in a state of fullness in order to aerate the Jingmai and chase away the perverse energy. It is also recommended to prescribe a decoction of Ban Xia (Pinella t u b e r i f e r a ) . When the circulation of Yin and Yang becomes reestablished, the individual regains his sleep.” Huangdi: “Precisely! This is then a method of “deobstuction” in the case of engorgment, a method of “ a e r a t i o n ” of the Jingmai, in order to reestablish the equilibrium of Yin and Yang. I would like you to teach me about this decoction.” 293.

Ba Gao: “One uses 8 sheng of water originating from a remote source of 10,000 li ( 2 ) . This water is conserved in a receptical shaken 10,000 times. Allow the water to sit until it becomes clear. Withdraw 5 sheng of this clear water which one brings to a boil. As it is combustible, use stalks of reeds. Upon boiling add 1 sheng of sticky rice and 0.5 don of Ban Xia. After filtrating it, make the patient drink a small cup of this decoction, three times a day, and increase the dose according to the seriousness of the illness. In recent illness, the first of this decoction is sufficient to amke sleep return. Transpiration is the sign of its effectiveness. In chronic illness, 3 of this decoction assures cure.”

EXLANATIONS AND COMMENTARIES I - Zhang Shi explains:

“1 - “To tonify the insufficiency” is to needle the point of exit of the Yinqiao, that is to say, Zhaohai (Ki 6), belonging to the Foot Shaoyin (Ki). “To disperse the excess” is to needle the point of exit of the Yangqiao, that is to say, Shenmai (Bl 62), belonging to the Foot Taiyang (Bl). In cases of fullness of Yin and emptiness of Yang with frequent desire to stretch out (clinomania) (3), it is advised to tonify Yang and disperse Yin.

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2. 1 Li = 0.04 cm. 3. Excessive desire to stay in bed.

2 - Ban Xia (4) (Pinellia tuberifera), oval in shape and both sweet and spicy in flavor, responds to the Foot Yangming (St). The 5th month (lunar) is the period of production and growth of Ban Xia. Ban Xia receives the energy of the first Yin to be produced. The stomach responds to Wu-Earth (Wu = 5th Celestial Stem). 294. The kidney conserves Tian Gui (Celestial Gui) (5) responding to the “Water” movement. As a result, once absorbed, Ban Xia awakens the energy of first Yin and goes into relationship with the stomach. Due to the union of Wu (5th Celestial Stem) and Gui (10th Celestial Stem), the energy of 1st Yin becomes transformed into great energies, Fire and Water, whose role is to reestablish the equilibrium of Yin and Yang, interior and exterior, primary factor in sleep. It is a matter then of one of the methods of “deobstruction of the arroyo”, the method of “aeration” of the Jingmai (principal channels) or “harmonization” of Yin and Yang.

3 - The kidney is the Water Organ. It is also the producer organ of the energy. When the energy circulates, water freely flows out. • The stomach, bowel of Humidity-Heat, governs Center-Earth. As a result, the union of Yin and Yang is a factor of production/transformation of “Water-Cold. This is why one uses water from a remote source of 10,000 li. • One shakes the water vigorously because this is of a nature “without force” and, without that, it cannot aid Water-Cold to circulate. • If the number of doses of Ban Xia (Pinellia tuberifera) is 8 Sheng and 5 sheng respectively, this is because: _ 8 is the number of production/transformation of Water, _ 5, the number of formation/maintenance of Earth. These numbers are intended to reinforce the action of the energy of the stomach. • One uses reed stalks to burn to create a big fire to activate boiling, therefore rapidly obtaining the expected decoction. • Sticky rice is a cereal responding to Earth and ripens in autumn. Its energy maintains that of the stomach because the ease of the abdomen and evacuation of urine and fecal matter was the two major preoccupations of ancient Chinese medicine.”

4. Cf. “Pharmacology in Oriental Energetic Medicine”, Nguyen Van Nghi and Mai Van Dong, NVN Edition. 5. “Gui” is the 10th Celestial Stem. It corresponds to the “Water” (kidney) movement. Among the Celestial Stems: _ Ren, 9th Celestial Stem, is Yang, _ Gui, 10th Celestial Stem, is Yin. In the present case, _ Ren represents the concentration of the energy, that is to say, the movement of Yang going toward Yin (concentration). _ Gui represents the manifestation of the energy, that is to say, the movement of Yin going toward Yang (manifestation). Here, these 2 terms are therefore envisioned in their dynamic aspect as had been de meme que l’avaient ete Jia (1st Celestial Stem) and Yi (2nd Celestial Stem). According to Qi Bo, Celestial Gui is innate. It is reinforced “a posteriori” by dietary Jing (quintessence).

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II - N.V.N.: Zhang Jing Yue furnishes us with the following information: 1 - “The “3 direct routes” (San Sui) are: _ the route of wastes, activated by Xiajiao (Lower Jiao- LJ) _ the route of Xin-Ye (water originating from food metabolism), activated by Zhongjiao (Middle Jiao- MJ) _ the route of Zong Qi (innate, ancestral energy), activated by Shangjiao (Upper Jiao- UJ). 295.

• The larynx, belonging to the lung, is linked to the heart by an energetic vessel. As a result, Zong Qi (ancestral energy) reaches the larynx to activate the respiratory movements. • Regarding the circulation of Ying Qi (nutritive energy), one must reread Chapters 15 (“Fifty Rong“) and 16 (“Nutritive Energy“) of this classic. Regarding the circulation of Wei Qi (defensive energy), one must reread Chapter 43 (“Discourse on Obsrtuctions”) and Chapter 10 (“Vessels-Channels”) of this classic. 2 - Tonification and dispersion are two techniques of acupuncture. But acupuncture is usually associated with phytotherapy. Ban Xia (Pinellia tuberfiera) is a specific plant in the treatment of insomnia, a medicinal plant known since antiquity. • Sticky rice has the property of treating fullness of Yang and emptiness of Yin, fundamental factors in insomnia. • Ban Xia increases the potential of Yin and reinforces the large intestine tract.”

PARAGRAPH 2 Huangdi: “I would like you to inform me about the correlations between the “4 limbs 100 articulations”, Heaven and Earth.” Ba Gao: “_ Heaven is round, and Earth, square (6). The head of man is round, and his feet are square. _ Heaven has at its disposal the sun and moon and the 2 eyes of man. _ Earth is endowed with “9 regions”, and man, with “9 orifices”. _ Heaven has at its disposal wind and rain, and man, joy and anger. _ Heaven emits thunder and lightning, and man, sounds and voice. _ Heaven possesses 4 seasons, and man, 4 limbs. _ Heaven is endowed with 5 sounds (musical), and man, 5 organs. _ Heaven possesses 6 laws (musical), and man, 6 bowels. _ Heaven has at its disposal winter, and man, cold and heat. 296. _ Heaven is endowed with “10 Celestial Stems” , and man, 10 fingers. _ Earth is endowed with “12 Terrestrial Branches” , and man, 10 toes, penis and testicles. Women do not have testicles and penis, but they possesses uterus and ovaries.

6. See explanation on the following page.

_ Heaven possesses 365 days, and man, 365 articulations (points of acupuncture). _ Earth is endowed with high mountains, and man, with shoulders and knees.

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_ Earth has at its disposal deep caverns, and man, axillae and popliteal fosae. _ Earth is endowed with 12 rivers, and man, 12 Jingmai (principal channels). _ Earth has at its disposal subterranean sources, and man, Wei (defensive) energy. _ Earth is covered with herbs, and man, hair. _ Heaven has at its disposal day and night, and man, awakening and sleep. _ Heaven possesses stars, and man, teeth. _ Earth is endowed with small mountains, and man, small bones. _ Earth possesses rocky mountains, and man, jutting bones. _ Earth possesses forests, and man, membranes and vessels. _ Earth is endowed with towns and villages, and man, prominent muscles. _ The year has 12 “moons” (months), and man, 12 great joints. _ Earth possesses sites where herbs do not sprout; in man, individuals are infertile. Such are the correlations between Heaven, Earth and man.”

EXPLANATIONS AND COMMENTARIES N.V.N.: 1 - Here, the words “Round” and “Square” do not desiignate geometric shapes but must be taken in the philosophical sense. “Round” represents Yang, and “Square”, Yin. • The word “Heaven” implies the sense of cyclic transmutation of the 6 energies: wind, heat, humidity, dryness and cold. 297. The word “Earth” designates material form (therefore visible). Ex: mountain, river, wheat, rice... . In order to live, the living being must obey the law of mutations of Heaven and Earth. Also, in Chapter 5 of the Suwen (“Phenomena of Correspondences of Yin and Yang”), we read: “ •Heaven has Jing (pure energy), and Earth, Xing (form). _ Beginning of spring _ Beginning of summer _ Beginning of autumn _ Beginning of winter _ Spring equinox _ Summer solstice _ Autumn equinox _ Winter solstice, and the Earth has its Wu Li (5 regions): _ East _ West _ North _ South _ Center. 298. This is why Heaven and Earth become “father” and “mother” of all beings.

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Figure 1: Square and Round (symbol of harmony)

• Pure Yang rises up to Heaven, impure Yin descends to Earth. This is why movement and rest are the 2 sublime rules of the transformation, in an unbroken fashion, toward birth, growth, stagnation and conservation. • Only the sages envisioned the “head” part of the body in comparison to Heaven, the “foot” part in comparison to Earth and the “middle” part in comparison to “human affairs” to maintain the 5 organs.” 2 - The “9 regions” of Earth of the ancient era are: Jing Chou, Liang Chou, Yung Chou, Yu Chou, Si Chou, Yang Chou, Sheng Chou, Yue Chou and Qi Chou. 3 - The “9 orifices” of the human being are: _ 2 eyes _ 2 ears _ 2 nostrils _ 1 mouth _ 1 anal orifice _ 1 urethral meatus. 4 _ _ _ _ _

- The “5 fundamental sounds” of ancient music are: Jiao, which responds to Wood-Liver Zhi, to Fire-Heart Gong, to Earth-Spleen Shang, to Metal-Lung Yu, to Water-Kidney (7).

5 - The “8 Laws” of Heaven designate the 8 fundamental rules of ancient music bearing the name “Huang Chong”. It concerns the laws of modification of musical sounds whose tonalities respond to the 6 bowels.

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PARAGRAPH 3 Huangdi: “Please _ _ _ _ Cou Li

inform

me

about:

the rules of needle manipulation, the principles of acupuncture practice, the meaning of “ t o n i f i c a t i o n ” and “ d i s p e r s i o n ” , the method of “stretching the skin (massage) to facilitate the opening of (junction between the skin and muscles) during removal of the needle. 299.

me:

How do you understand these problems? I would also like you to clarify for

_ the well-ordered and winding routes of the Jingmai, _ the sites of entry/exit, acceleration/slowing down and stoppage/ departure of the energy, _ and also the activity of the Shu (antique) points of the 6 bowels at the level of the body.” Ba Gao: “The answer to the problem raised by His Majesty is to be found in the Dao of Acupuncture.” Huangdi: “I would like you to speak about this to me in detail.” Ba Gao: “1. The Hand Taiyin (Lu) vessel emerges at the tip of the thumb (at the point Shaoshang- Lu 11), _ curves toward the internal side (energetic description) running alongside the boundary of the white flesh, _ reaches the internal side (energetic description) of the thenar eminence, _ and reaches the point Taiyuan (Lu 9) where it breaks off changing into the skin. 7. See Chapter 64 (“Yin and Yang and the 25 Morphotypes”) of the Lingshu.

• It comes back out at the point Taiyuan (Lu 9) to ascend to the wrist fold, _ arrives at the region of Yuji (Lu 10) where it unites with the Luo Yin. At this level, its energy and that of the Luo Yin are very acive. • From Yuji (Lu 10), it circulates deeply at the level of the bone (first metacarpal) toward Cun Kou (radial pulse), _ resurfaces by the point Jingqu (Lu 8), _ runs alongside the internal side (energetic description) of the forearm, _ arrives at the fold of the elbow, _ penetrates under the big tendon (of the biceps) where the point Chize (Lu 5 ) is found, _ curves toward the interior where it reaches the inner arm, _ penetrates into the axilla

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_ and is directed toward the lung organ. Such is the contrary circulation of the Hand Taiyin (Lu) going from the hand to the thorax, in comparison to the f a v o r a b l e circulation of the energy of the lung going from the thorax to the hand. 300.

2 - The Hand Jueyin (Xin Bao- XB) vessel emerges at the tip of the middle finger at the point Zhongchong (XB 9), _ curves toward the internal side (energetic description) _ runs alongside the internal side (energetic description) of the middle finger. _ stops at the middle of the palm of the hand a the point Laogong (XB 8), _ circulates between the 2 bones (2nd and 3rd metacarpals), _ exteriorizes at the middle of the wrist fold, between 2 tendons of the muscles (large and small palmaris), where the point Daling (XB 7) is found. At this level, its energy is very active; _ reaches the forearm, 2 cun from the wrist, at the point Neiguan (XB 6), _ curves between 2 tendons where the point Jianshi (XB 5) is found, _ is directed toward the middle of the elbow fold, _ stops at the point of reunion of the 2 bones, that is to say, inside the tendon of the biceps brachial where the point Quze (XB 3) is found, _ ascends and penetrates into the middle of the thorax _ links up with the vessle of the heart. This circulation is “ c o n t r a r y ” (from hand to thorax) to the “ f a v o r a b l e ” trajectory of the Hand Jueyin (XB) which goes from thorax to hand.”

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains: “This paragraph and the follwoing one speaks on the “contrary” circulation of the Hand Taiyin (Lu) and Hand Jueyin (XB) as a function of the Shu-antique points. 1 - The energy of the lung emerges at the tip of the thumb at the Jing point, 1st Shu antique point, that is to say, at the point Shaoshang (Lu 11), responding to the “Wood-Liver” movement. From the Jing point, it goes directly to the Yuan point, 3rd Shu-antique point, that is to say, to the point Taiyuan (Lu 9), responding to the “Earth-Spleen” movement. Then from there, it returns to the Ying point, 2nd Shu-antique, that is to say, to the point Yuji (Lu 10), responding to “Fire-Heart”, because the thenar eminence is the zone of reunion of all the Luo Yin. At this level, the energy of the lung is very active. From the Ying point, it is directed again to Cun Kou (radial pulse) to emerge at the level of the Jing point, 4th Shu-antique point, that is to say, at the point Jingqu (Lu 8), responding to the the “Metal-Lung” movement. From the Jing point, it passes to the He point, 5th Shu-antique point, that is to say, to the point Chize (Lu 5), responding to the “Water-Kidney” movement. 301. And finally, from the He point, it is directed into the thorax and penetrates into the lung. The “favorable” circulation of the Hand Taiyin (Lu) goes from the organ to the hand. In contrast, the circulation described in this paragraph goes from the hand to the thorax. This is why it is said: “Departure is favorable, and return is contrary”.

2 - The energy of the Xin Bao Luo (XB- Hand Jueyin) emerges at the tip of the middle finger at the Jing point, 1st Shu-antique point, that is to say, at the point Zhong Chong (XB 9), responding to the “Wood-Liver” movement;

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_ reaches the middle of the palm to the Ying point, 2nd Shu-antique point, that is to say, at the point Laogong (XB 8), responding to the “Fire-Heart” movement, 302... _ is directed toward the middle of the wrist crease to the Yuan point, 3rd Shu-antique point, that is to say, to the point Daling (XB 7), responding to the “Earth-Spleen” movement, _ arrives at the Jing point, 4th Shu-antique point, that is to say, at the point Jianshi (XB 5), responding to the “Metal-Lung” movement, _ is directed toward the He point, 5th Shu-antique point, that is to say, to the point Quze (XB 3), responding to the “Water-Kidney” movement, _ and reaches the thorax to penetrate nto the heart. This circulation goes from the hand to the thorax. It ia a question therefore of a circulation called “in the wrong direction” (contrary) of the Hand Jueyin (XB). This is why it is said: “Departure is favorable, and return, contrary”.”

II - N.V.N.: This paragraph raises the problem of the circulation in the wrong direction of the Jingmai, concerning the Hand Taiyin (Lu) and Hand Jueyin (XB). For the remainder, Chapters 2 (“Origin of the Shu-antique Points”) and 10 (“Vessels-Channels”) of this classic are interesting to consult.

301.302.

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Figure 2: Figure 3: Normal circulation and circulation in the wrong direction: Hand Taiyin (Lu) Hand Jueyin (XB)

PARAGRAPH 4

303...

Huangdi: “The Hand Shaoyin (He) is the only vessel not having specific Shu p o i n t s (8). Why?” Ba Gao: “The Hand Shaoyin belongs to the heart The heart is sovereign organ of the 5 organs and 6 bowels. It is the dwelling place of the Jing (quintessence) and of the Shen (mental). It is of strong temperment. This is why perverse energy cannot infiltrate to it. In the case where it reaches there, the heart is damaged. The damaged heart brings about the disappearance of the Shen (mental); this is death. Therefore, to speak of perverse energy located at the heart is to designate the localization of perverse energy at the level of the Xin Bao Luo ( 9 ) . The Xin Bao is the vessel whose “master” is the heart. It possesses Shu points (specific points: Shu-antique points) to supply the heart. This is why the Hand Shaoyin (He) does not possess Shu p o i n t s . ” Huangdi:

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“The Hand Shaoyin (He) being the only one without s h u points, is it true that it is protected from all illnesses?” Ba Gao: “When the Hand Shaoyin (He) is affected, the illness remains at the channel; it does not reaxh the organ (heart). In this case, one only uses the point at the tip of the pointed bone (styloid process of the ulna) behind the palm of the hand, that is to say, the point Shenmen (He 7). As for the rest of the channel (Hand Shaoyin- He), the “ c o n t r a r y ” or “favorable”, “slow” or “ r a p i d ” circulation takes up that of the Hand Jueyin (XB). This is why Shenmen (He 7) is considered as the unique Shu point of the Hand Shaoyin (He). 304. In the event of illness, Shenmen (He 7) must be needled as a function of the emptiness or fullness of this vessel (Hand Shaoyin- He). In other words, in the event of fullness of perverse energy, one must use the technique of dispersion, and in the event of emptiness of essential energy (of the body), the technique of tonification. To practice in this manner is to eliminate the perverse energy and consolidate the source energy (Cheng Qi) based on the Celestial Order (manipulation at the level of the Jingmai transmitted via cosmic energy). ”

8. Designates the Shu-antique points. 9. Energetic vessels envelopping the heart.

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains:

“The Hand Shaoyin is the channel of the heart. The Hand Jueyin (XB) is the channel of the Xin Bao (XB- envelope of the heart). These 2 channels originate from a single organ, the heart organ. The Xin Bao (XB) is the protective envelope of the heart, and the heart is the sovereign organ where the Jing (quntessence) and the Shen (mental) lives. As a result, the Xin Bao has the heart for its “master”, hence the name “Master of Heart” (Xin Zhu). • The heart, sovereign organ, cannot be attacked by perverse energy. But its channel, like all other channels, is susceptible to exposure to infiltration by cosmic energy. This is why one uses Shenmen (He 7) to treat ailments of the Hand Shaoyin (He) according to the technique of tonification in the case of emptiness of the essential energy of the body or the technique of dispersion in the case of fullness of perverse energy.”

II - N.V.N.: 1 - According to Chapter 2 of this classic (“Origin of the Shu-antique Points”) (10), the 5 organs (Lung, Master of Heart/Xin Bao, Liver, Spleen and Kidney) each possess 5 Shu (antiques, specific) points and the bowels each 6 Shu points, except the heart. Huangdi’s question allows elucidation of the reason for the absence of Shu (antique) points at the levelof Hand Shaoyin (He). According to Ma Shi:

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“The heart is the Great Director√ of the 5 organs and 6 bowels. It must not be attacked by perverse energy. The Xin Bao Luo (XB) and the heart channel (Hand Shaoyin) communicate and act as substitute for the “Royal Master” (heart) in order to command all organic functions. When one uses needles, the needling is generally only performed on the Xin Bao (XB). This is why the Shu (antique) points belonging to the Xin Bao (XB) are used in place of those of the Hand Shaoyin (He).” 305.

2 - The 5 Shu (antique) points of the Hand Shaoyin (He) have only been indicated from the time of the Han Dynasty (206-220 A.D.) by the grand master acupuncturist Huangfu Mi (215- 282 A.D.) in his famous work “Jia-Yi Jing”. These points are: 1) Shaochong (He 9): Jing point responding to the “Liver-Wood” movement, 2) Shaofu (He 8): Ying point responding to the “Heart-Fire” movement, 3) Shenmen (He 7): Yuan-Shu point responding to the “Spleen-Earth” movement, 4) Lingdao (He 4): Jing point responding to the “Lung-Metal” movement and 5) Shaohai (He 3): He point responding to the “Kidney-Water” movement. In our era, these points are perfectly known and classified.

10. See Lingshu, Volume I, N.V.N. Edition.

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Figure 4: Trajectory of the Hand Shaoyin (He) and its points.

PARAGRAPH 5 Huangdi: “What

is

306.

the

significance

of

tonification

and

dispersion

in

acupuncture?”

Ba Gao: “First, it is necessary to know: _ the “root” (point of departure) and “summit” (point of arrival) of the 12 Jingmai, _ the cold and heat of the skin, _ the excessive and insufficient state and “slippery” (Hua) and “rough” (Se) nature of the pulse. • The slippery and full pulse indicates the worsening of the illness. The empty and galloping pulse heralds the insufficiency of the essential energy (of the body) and the chronicity of the illness. • If Yin (interior) and Yang (exterior) are simultaneously affected, the illness is difficult to treat. If heat (fever) persists in the thoraco-abdominal region and at the level of the limbs, the perverse energy is still localized within the body. If heat is not located in these regions, this is cure. • Furthermore, one must examine the skin of the “Chi” region (region of the anterior surface of the forearm, between elbow and wrist) n order to determine:

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_ the state of firmness of the muscles _ and the character of the pulse, which can be s l i p p e r y or r o u g h , with the purpose of specifying the state of Cold/Heat and Dryness/ Humidity. • One must also examine the 5 colors at the level of the eyes in order to determine the state of the 5 organs with the purpose of predicting the benign or serious state of the illness. In this manner, knowledge of the Jingmai and examination of the colors are fundamental to the determination of the syndromes of Cold and Heat and the Tong Bi syndromes (algoparesthesia of rheumatic origin). ” Huangdi: “I still have not grasped very well the method of manipulation of the needle during tonification and dispersion.” Ba Gao: “The Dao of needling demands the proper attitude and a tranquil mind. 307.

First, one must know the state of emptiness and fullness of the illness in order to apply the technique of tonification and dispersion as a function of movements of rapid or slow rotation transmitted to the needle. The left hand presses on the area to be needled, and the right hand secures the sought-after point on the trajectory of the channel. The implantation of the needle must not be abrupt to avoid reactions at the level of the tissue fibers (which occur around the needle and provoke pain). Dispersion demands a vertical implantation of the needle, and tonification necessitates the closure of the needled point (with the aid of the finger) during removal of the needle. The method of “conduction of the energy” is also utilized to prevent the overflowing of the energy toward the interior in the goal of calming the Chen Qi (source energy: essential or vital energy) and helping it to circulate normally.” Huangdi: “How do you practice “ t a p p i n g ” , the method of massage (by small light taps with the aid of the fingers or edge of the hand) to facilitate the opening of Cou Li (junction between the dermis and muscles) ? ” Ba Gao: “One taps the area to be needled delicately with the aid of the left hand, then one softly and vertically implants the needle with the right hand so as not to disturb the Shen (mental) of the patient to eliminate perverse energy.”

EXPLANATIONS AND COMMENTARIES N.V.N.: 1 - “Yin and Yang are simultaneously in emptiness”. According to Zhang Jing Yue, in the case of concomitant emptiness of the interior (Yin) and exterior

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(Yang), of bllod (Yin) and energy (Yang), acupuncture is strictly prohibited. 2 - “Examine the Chi” region (“foot” pulse)”, that is to say, examine the region of the forearm, between wrist and elbow, where the “Chi” pulse (“foot” pulse) is found. In Chapter 4 (“Pathologic Forms of Attack of the Organs and Bowels by Perverse Energy”), (Paragraph 7), of the Lingshu (11), we read: “...When the pulse is slippery, the “Chi” area of the skin is also slippery. When the pulse is rough, the “Chi” area is also rough... .” 308. In other words, the physician examines the slippery and rough state of the skin of the “Chi” region in order to determine the potential degree of Cold and Heat, Dryness and Humidity, of blod and energy to appreciate: _ the state of the 5 organs _ and the state of the blood routes (blood Luo) and pilo-cutaneous system to diagnostic ends of Cold/Heat of Tong Bi (algoparesthesia: pain and engorgement caused by obstruction). 11. Volume I, N.V.N. Edition.

• In Chapter 56 (“Discourse on the Cutaneous Regions”) of the Suwen (12), devoted to the study of the cutaneous territories of the Jingmai, the determination of the paths of penetration of perverse energy and the search for the evolutive nature of the disease toawrd a therapeutic goal, we read: Huangdi: “I have heard it said: _ that the skin is divided into 12 regions following the system of the 12 Jingmai (vessels of principal paths), _ that the muscles possess a system of “relations-unions” _ and that attacks of these different regions are necessarily different. The skin then is divided into “Left-Right”, “Top-Bottom, “Yin-Yang” regions; how do you explain the pathophysiologic and evolutive mechanism of diseases as a function of these criteria?” Qi Bo:

“One determines the division of cutaneous regions based on the zones of passage of the Jingmai and Luomai. In other words, the cutaneous covering has the same correspondences as the system of “Mai” (vessels). 309.

• The Luo Yang of the Yangming channel is called “Hai Fei” (very harmful influence: “closure”). The Hand and Foot Yangming (LI and St) also bear the same name. The appearance of “Fu Luo” (superficial energetic network) as much in the upper as in the lower part √of the Yangming belongs to the Luomai of this channel. The appearance of a green color at the level of this network indicates pain. The appearance of a blackish color indicates “Bi” (obstruction). The appearance of a yellow-red color denotes a disease of “Heat”. the appearance of a white color reveals a disease of “Cold”. The simulatneous appearance of all 5 colors affirms a disease of “Cold-Heat”. When the perverse energy of this Luomai is in fullness, it reaches the corresponding Jing. The Luomai is Yang; it governs the exterior. The Jingmai is Yin; it governs the interior. As a result, perverse energy advances from the exterior toward the interior, from Luo to Jing. • The Luo Yang of the Shaoyang channel is called “Shu Chi” (rigid flesh). The Hand and Foot Shaoyang (SJ and GB) also bears the same name.The appearance of “Fu Luo” (superficial energetic network) in the region of this channel belongs to the Luomai of the Shaoyang. When the perverse energy of this Luomai is in fullness, it progresses toward the corresponding Jing (channel). This is why, from the Yang part, perverse energy reaches the interior, and when it occurs in the Yin part, it leaves the channel to infiltrate into the organ. This evolution is the same for all the channels.

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• The Luo Yang of the Taiyang channel is called “Guan Shu” (barrier of the flesh, “opening”). The Hand and foot Taiyang (SI and Bl) also have the same name. The appearance of “Fu Luo” in the region of this channel belongs to the Luomai of the Taiyang. When the perverse energy of this Luomai is in fullness, it progresses toward the Jing corresponding (channel)...”.

12. “Huangdi Nejing Suwen”, Volume III, page 287. 13. From 1970, based on these different chapters of the Lingshu, we have been able to demonstrate the analgesic action of acupuncture (see “Acupuncture in the West- The History by the Image of the Period 1971-

1981”).

PARAGRAPH

6

Huangdi: “Man possesses “8 Xu” (small empty spaces: interstices, fissures). What do they represent?” Ba Gao: “When perverse energy reaches the lung and heart, it remains securely at the 2 elbows. When perverse energy reaches the liver, it most probably stops at the axillae. When perverse energy reaches the spleen, it obviously stays at the 2 inguinal creases (thigh and groin). When perverse energy reaches the kidney, it most probably settles at the 2 popliteal fossae. 310.

These “8 Xu” (2 elbows, 2 axillae, 2 inguinal creases and 2 popliteal fossae) not only represent the joints where the Cheng Qi (source, vital or essential e n e r g y ) passes, but also the sites of development of the blood Luo. Perverse energy and blood must not stop at these places because their retention injures the tendons, Luo, bones and joints, hence spasms of the limbs.”

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains: “The lung and heart have their Jingmai located on the upper limbs. When perverse energy reaches these organs, it must stop first at the 2 elbows, at the points Chize (Lu 5) and Shaohai (He 3). The liver and gallbladder have their “Yin-Yang” system at the level of their channels located on the foot. When perverse energy reaches this organ and bowel, it must settle first in the axillae, that is to say, at the points Qimen (Li 14) and Yuanye (GB 22). The spleen and stomach have their “Yin-Yang” system at the level of their channels on the foot. When perverse energy reaches this organ and bowel, it must remain first in the groin region, that is to say, at the points Zhongman (Sp 12) and Qichong (St 30). The kidney and bladder have their “Yin-Yang” system at the level of their channels located on the foot. When perverse energy reaches this organ and bowel, it must stay first at the popliteal fossae where the points Yingu (Ki 10) and Weizhong (Bl 40) are found. The “8 Xu” cited in this paragraph are “”private dwelling places” of the 5 organs, sites of passage of the Cheng Qi (essential energy) and sites of “reunion-gathering” of the blood Luo. This is why perverse energy must

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not remain there; if it reaches there, it causes joint blockage, hence spasm of the limbs.” II - N.V.N.: This paragraph involves the pathologic process of spasm of the limbs whose theapy depends on the reason for the blockage of energetic origin. The word “Xu” (emptiness) used in this paragraph must not be understood in the sense of insufficiency used in pathology, but in the sense of “the collection of soft and hard parts by which 2 or more adjoining bones are united: “joints”. In energetic medicine, the joints are the sites of passage of the energy and blood. In Chapter 10 of the Suwen (“Production and Transformation of the Organs”), the “8 Xu” (8 emptinesses) are named “8 Xi” (8 valleys): “_ All energetic vessels gather at the eyes, _ all marrows, at the brain, _ all muscles and tendons, at the joints, _ all energies, at the lung, _ all blood, at the heart. Day and night, all pass and pass again the “8 Xi” (valleys).” Zhang Jing Yue concludes: “The 8 Xi” (8 emptinesses) are well-guarded and kept paths of the passage of Cheng Qi (essential energy), Qi (energy) and Xue (blood). If perverse energy becomes lodged there, it causes disturbances of flexion and extension whose localization indicates pathology of the corresponding organs.” 311.

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Figure 5: The “8 Xu”: 2 elbows, 2 axilla, 2 groins and 2 popliteal fossa. no 312/313.

CHAPTER LXXII Celestial Relations (Zhong Tian)

Chapter 72 of the Linghsu speaks on the 5 types of man according to the Yin and Yang of Heaven, or more precisely, according to the “4 Celestial Aspects” (Si Xiang). These 5 types of man are the: _ Taiyin type _ Shaoyin type _ Taiyang type _ Shaoyang type _ “Well-Balanced Yin-Yang” type. Each type is endowed with a different temperment, a temperment created a priori by “Heaven”. The term “Zhong Tian” (Celestial Relations) implies that, despite these different constitutions, the human being always retains the innate nature furnished by the Yin and Yang of Heaven and Earth (that is to say, by the parents). This chapter contains 3 paragraphs: 1. Morphology and temperment of the 5 types of man (responding to the “4 Celestial Aspects”). 2. Treatment by acupuncture.

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3. Methods of appreciation and determination of these 5 types of man.

PARAGRAPH 1

314.

Huangdi questions Shao Shi: “I have often heard you speak of the 2 types of man: the “Yin” type and the “Yang” type. How are they distinguished?” Shao

Shi replies” “In the “Heaven-Earth” space, the 6 regions (4 cardinal points + top and bottom) are linked to the number 5. Man also conforms to this rule. As a result, there is no man of only Y i n type or only Yang t y p e . It is too cursory to speak of 2 types. One cannot describe them clearly.” Huangdi: “I would like to know only the essentials. Sages and men of virtue are made u p √ in their “heart” of Yin and Y a n g . Can this Yin and this Yang manifest at the exterior by objectively observable temperments?” Shao

Shi: “In a general fashion, there are men of Taiyin, Shaoyin, Taiyang, Shaoyang types and men of “Well-Balanced Yin-Yang” t y p e . These 5 tpyes of men are morphologically different. Their musculature and bony structure, their blood and energy, are also different.” Huangdi: “Could you instruct me about this typology?” Shao

Shi: “1. The man of “ T a i y i n ” type is greedy and inhuman. On appearance, he has the air of modesty and scrupulousness, but sly meanness accumulates in the interior. He only looks after his own interest and does not like to lose out. He appears correct and appealing and is not expressive. He is extremely cunning and only reveals himself after others√ . Such are the characteristics of the heart” (temperment) and behavior of the “ T a i y i n ” type of man. 2. The man of “ S h a o y i n ” type is greedy for small gains. He thinks only of doing harm to others. He is deceitful; the misfortune of others brings him joy. He often is given to anger when affairs of others are crowned with success. He is cruel and ungrateful. Such are the “characteristics of the heart” (temperment) and behavior of the

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“ S h a o y i n ” type of man. 3. The man of “Taiyang” type takes little interest in his residence; he feels sick everywhere within himself and leads an unstable life. 315. He likes to to give dissertation on great events. Devoid of talent, he is devoted to hollow phrases and brags of his exploits. In his actions, he does not care about good or bad; he always has a reason. The results of his work is poor, but he is confident and proud. He does not repent in spite of errors. Such are the “characteristics of the heart” (temperment) and behavior of the “ T a i y a n g ” type of man. 4. The man of “ S h a o y a n g ” type is meticulous and conscientious. He considers himself more talented than others. When one confides in him a little poste de m a n d a r i n √ , he becomes proud and pretentious. He is focused on matters of the exterior (diplomacy), but he is incapable of dealing with matters of the interior. Such are the “characteristics of the heart” (temperment) and behavior of the “ S h a o y a n g ” type of man.

the

5. The man of “Well-Balanced Yin-Yang” type like a peaceful and calm life. Nothing alarms him and he does not rush after pleasures. His activities conform with the Rules of Nature. He only seeks to live according to the evolution of time. Despite his honorable situation, he remains humble. He utilizes virtue, never force, to persuade others. This attitude is brilliant in rules of affairs.

• In ancient times, physicians used acupuncture and moxabustion to treat patients as a function of the 5 types of man cited above according to the method of tonification in the event of emptiness and the method of dispersion in the event of fullness.”

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains: “1- The “1st Yin” and “1st Yang” are Liang Yi (two principles of mutations) (1) which derive from se produire? during creation of the world (Heaven-Earth). They respond to the type of man whose Yin and Yang are balanced. Si Xiang (4 aspects) (2) derive from the mutation of Liang Yi (1st Yin + 1st Yang) and respond: _ to Taiyang corresponding to the number 1 (odd) 316. _ to Shaoyin corresponding to the number 2 (even) _ to Shaoyang corresponding to the numebr 3 (odd) _ to Taiyin corresponding to the number 4 (even) and to men of the Taiyang and Shaoyang, Taiyin and Shaoyin type.

2- Man receives the energy of Heaven and Earth to create Xing (form) and Qi (energy). Chapter 64 of this classic (“Yin and Yang and the 25 Morphotypes”) speaks about the creation of Xing (form) via the 5 Movements of the Earth, while this Chapter 72 studies Yin and Yang of Heaven and Earth (Liang Yi) which creates the “4 aspects” (Si Xiang) of the space

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1, 2. See explanations in “I Jing” (“Book of Changes”)

responding to the “Taiyin, Shaoyin, Taiyang and Shaoyang” in order to study the temperments of the living being. This is why this chapter is entitled “Zhong Tian” (“Celestial Relationships”). 3- “...To diminish by modesty and demonstrate humility when one takes interest in high function” is a good mark of humility. In the past, Hu Kou advanced: “Man, for 3 reasons, gives rise to hatred and jealousy: a) High-placed government official gives rise to jealousy. b) High-ranking mandarin gives rise to hatred of master. c) Too much good fortune gives rise to resentment.” And Xun Shu wonders: “The higher my rank, the lower will be my mind√. _ The greater my function, the smaller will be my heart. _ The more considerable my good fortune/happiness√, the more important will be my gift to others. In this fashion, will I avoid these 3 hatreds?” The question and response of Xin Shu conform to the theme of the text. 4- In the past, the capable physician utilized the needles and leaves of mugwort (Artemesia) to teat diseases, knew perfectly how to discern the temperment of these 5 types of man, in order to apply the method of tonification in case of emptiness and the method of dispersion in case of fullness.”

II - N.V.N.: The explanations of Zhang Jing Yue are in total accord with that of Zhang Shi: “1- The Sage differs from from ordinary man by his perfect harmony of “Yin-Yang”. 2- The words “Taiyin, Shaoyin, Taiyang and Shaoyang” utilized in this paragraph do not designate the channels of the foot and hsnd (Hand and Foot Taiyin, Hand and Foot Shaoyin, Hand and Foot Taiyang and Hand and Foot Shaoyang). In effect, _ man receiving only the Yin of Heaven bears the name “Taiyin”, 317. _ man receiving more Yin than Yang is named “Shaoyin”, _ man only receiving the Yang of Heaven is called “Taiyang” _ and man receiving more Yang than Yin is designated “Shaoyang”. In this manner, one distinguishes 5 types of man according to the reception of Celestial energy. Clinically, the practitioner cannot ignore these facts because disease of blood and energy, during its evolution, becomes directed: _ either toward Yin, _ or toward Yang, _ or toward cold, _ or toward heat, _ or toward “well-balanced Yin-Yang”.”

PARAGRAPH 2 260

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Huangdi: “How do you treat these 5 types of men?” Shao

Shi: “1. In the “ T a i y i n ” type, Yin is very rich, and Yang, very poor. In him: _ Yin-Yang is disturbed by Wei Qi (defensive energy), not very fluid, _ Yin and Yang are lax _ the muscles are lax _ the skin is thin. If dispersion os not performed in time, the disease does not improve.

2. In the “ S h a o y i n ” type, Yin is in excess, and Yang, in insufficiency. In him: _ the stomach is small and the intestines are large, _ the 6 bowels do not function regularly, _ the energy of Yangming (St) is in insufficiency and that of the Taiyang (Bl) in excess. 318. This is why one must carefully examine him before applying treatment. Otherwise, the energy can no longer retain the blood and the Yuan Qi (sourceenergy) is rapidly exhausted. 3. In the “ T a i y a n g ” type, Yang is very rich and Yin is very poor. One must carefully examine him (due to the lack of Yin). Do not let the Yin escape. Only disperse Yang. If the dispersion is excessive, it can cause the escaping of Yang ending up in “agitated madness” (Kuang). If Yin and Yang have simultaneously escaped, death is sudden or else the patient suddenly falls into coma. him:

4. In the “ S h a o y a n g ” type, Yang is in excess, and Yin, in insufficiency. In

_ the Jingmai are small and the Luomai are large corrected! p.320, _ blood is localized in the interior, and the energy, at the exterior. During treatment, one must render the Jingmai “full” (principal channels located deep: Yin) and lightly disperse the Luomai (secondary vessels located superficially: Yang). If one only disperses the Luo Yang, Yang is forced to escape to the exterior; the Zhong Qi (“center” energy) then becomes insufficient, and the patient, difficult to treat. 5. In the “Well-Balanced Yin-Yang” type, Yin and Yang are harmonious, and the circulation of the energy and blood is steady. During treatment, one must: _ carfully observe changes in Yin and Yang to discern the fullness of perverse energy and emptiness of the essential energy (of the body), _ and carefully examine the attitude of the individual to determine the excessive or insufficient state of the energy and blood. In the event of fullness of perverse energy, one must employ the dispersion method, and in the event of emptiness of essential energy, the tonification method. In the event of the absence of fullness and emptiness, one must base one’s

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judgment on the channels to choose the points to needle. • The therapeutic rules cited above constitute the methods of “Regulation of Yin and Yang” serving as a basis of diagnosis and treatment applied in the 5 prototypes of man.”

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains:

319.

“1- In the “Shaoyin” type... the stomach is small, and intestines, large. The Jing Qi (energetic quintessence) released at the level of the Zhongjiao (Middle Jiao- MJ) and that produced at the level of the Xiajiao (Lower Jiao- LJ) are of the same origin (cereal). They each support one another. The insufficiency of the Yangming (St) and excess of the Taiyang (Bl) originate from the disequilbrium of acquired energy and innate energy, hence the easy escaping of blood and rapid exhaustion of the source energy (Yuan Qi, essential or vital energy). 2 - The previous paragraph speaks on the Yin and Yang of the exterior. This one studies the Yin and Yang of the interior. In the “Shaoyin” type, the disequilibrium of Yin and Yang of the interior rapidly causes the same phenomenon of disequilibrium at the exterior.” II - N.V.N.: 1 - “Small stomach and large intestines”. Here, this is based on the localization of the stomach (top = Yang) and intestines (bottom = Yin) in order to determine the phenomena of insufficiency (energetic) of the stomach and intestines. Zhang Jing Yue stated in this regard: “The Yangming (St) is the “sea” of the 5 organs and 6 bowels, and the intestines are evacuative bowels: _ small, the stomach does not contain much cereal and produces less energy, _ large, the intestines quickly evacuate them and fabricate very little energy. This occurs, therefore, before the phenomena of insufficiency of Yang and excess of Yin. In this case, the method of “Regulation of Yin and Yang” is absolutely advised. But before treatment, one must carefully observe these phenomena because the energy in insufficiency cannot retain the blood, hence escaping of blood (hemorrhage) and, during hemorrhage, the Yuan Qi (source energy) becomes rapidly exhausted.” 2 - “...The escaping of Yang results in Yang madness (agitated); death is sudden.” Zhang Jing Yue explained it in this manner: “Dispersion applied to Yin in a state of insufficiency causes escaping of Yin. This is why Shao Shi advised to not provoke the escape of Yin, but to only disperse the Yang. It is obvious that when Yin is in insufficiency, Yang no longer has a “root”. As a result, excessive dispersion of the Yang energy can cause a double escaping: _ escaping of Yang energy _ and escaping of the Yang Root, hence, sudden death or coma. 320.

This problem is very complex; it is recommended to reread Chapters 2 (“Harmonization of the mental Energy by the Four Seasons”), Chapter 23 (“Discourse on the Five Energies”), Chapter 40 (“Study on Abdomen-Center”) and Chapter 46 (“Discourse of Pathogenesis”) of the Suwen.” 3 - “The Jingmai are small and the Luomai are large”.

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This description is based on the notion “Biao-Li” (Exterior-Interior) in order to determine the energetic pathophysiology concerning the insufficiency of Yin and the excess of Yang. Zhang Jing Yue comments on this subject: “The Jingmai are deep; they respond to Yin. The Luomai are superficial; they respond to Yang. This is why, in the “Shaoyang” type, _ Yang is abundant and the Luo are large, _ Yin is insufficient and the Jingmai are small.”

PARAGRAPH 3 Huangdi: “I do not forget having already seen these 5 types of man. How should I distinguish them at first encountering them?” Shao

Shi: “Numerous are those who do not know how to distinguish these 5 types of man (responding to the “4 Aspects” of Heaven) because they do not make up part of the group of 25 morphotypes (responding to the “5 Movements” of Earth) describes previously ( 3 ) ...”. Huangdi: “How then can one recognize these types of man?” Shao

Shi: “1- The “ T a i y i n ” type is endowed with a skin that appears black like blackberries. He does not reveal his thoughts. His attitude is humble. His eyes are often fixed toward the bottom. His knees appear folded; he does not hold straight like an ox. Such is the man of “ T a i y i n ” type.

3. See Chapter 64 (“Yin and Yang and the 25 Morphtypes”).

321.

2- The “ S h a o y i n ” type has the appearance of a well-mannered man, but his attitude is furtive. He acts slyly with intention to harm. His mind is agitated; he walks with stooped back as if he wished to conceal his thoughts. Such is the “ S h a o y i n ” type of man. 3- The “ T a i y a n g ” type is proud and pretentious, arrogant and insolent. He walks with chest stuck out and belly sucked in. He believes himself to be superior to others. Such is the “ T a i y a n g ” type of man.

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4- The “ S h a o y a n g ” type is haughty. He walks with head high and body moving. The shoulders, arms and elbows are drawn toward the back. Such is the “ S h a o y a n g ” type of man. 5- The “Well-balanced Yin-Yang” type has a distnguished look. He knows how to adapt to all situations. He is affable and strict. He is conciliatory and expresses benevolence. He is is known to all as a serious and honest man. Such is the “Well-balanced Yin-Yang” type of man.”

EXPLANATIONS AND COMMENTARIES N.V.N.: We present below a synthesis of the behavior (character and actions), constitution, external morphology (appearance and attitudes) and treatment of these 5 types of man (responding to the “4 Celestial Aspects”). 1 - “ T a i y i n ” Type a) Behavior: _ ambitious and inhumane _ scrupulous to any point of view _ underhanded and malicious _ miserly (he detests spending) _ flexible mentality but withdrawn _ gestures and actions do not manifest at the same time.

b) Disposition/Constitution-√: _ Yin in abundance and Yang absent _ impure Yin-Blood _ Wei (defensive) energy not very fluid _ Yin and Yang in disequilibrium _ soft muscle and thick skin.

c) External Morphology: _ blackish color like blackberries _ humble attitude, but great ideas _ eyes fixed to the sun _ knees slightly bent in the standing position but without stooped back d) Treatment: _ Urgently apply the method of dispersion, otherwise the illness will be incurable.

2 - “ S h a o y i n ” Type a) Behavior: _ lusts after small profits _ full of deceitfulness

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322.

_ _ _ _

delighted at the misfortune of others likes to injure people and harm them rage in the face of success of others brutal and devoid of a spirit of benevolence.

b) Constitution√: _ Yin in excess and Yang in insufficiency _ Small stomach and large intestines c) External Morphology: _ dignifies air but furtive and scheming attitude with intention to harm _ walks like an hunchback as if he wanted to conceal his thought. d) Treatment: _ the bowels are in disequilibrium _ the Yangming (St) vessel is small _ the Taiyang (Bl) vessel is large. Before treatment, one must carefully examine them because: _ the blood easily can escape _ the energy is quickly exhausted.

3 - “ T a i y a n g ” Type a) Behavior: _ leads a stable life _ likes to brag and is pleased with lofty events _ devoid of talent, is devoted to empty words and deliberately praises his greatness _ crude and unpolished actions and attitudes _ ignores good and bad, truth and falsehood _ never repents of his faults.

b) Constitution: _ Yang in abundance and Yin in insufficiency. c) External Morpholgy: _ proud and pretentious appearance _ but stooped back and bent kness (signs of submission).

323.

d) Treatment: _ do not allow Yin to become exhausted. Only disperse Yang _ but excessive dispersion of the Yang energy results in “Yang-Madness” (agitated madness- Kuang).

4 - “ S h a o y a n g ” Type a) Behavior: _ serious work, but does not achieve doing well _ charged with a small position, but drawn to misplaced vanity _ likes external relationships, but incapable of assuming internal matters.

b) Constitution: _ Much Yang and not much Yin _ little Jingmai (principle channels), but large Luomai (secondary channels)

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_ blood in the interior and energy at the exterior _ fullness of Yin and emptiness of Yang.

c) Extenal Morphology: _ Haughty carriage, head usually raised and body waddling _ shoulders and elbows held to the rear. d) Treatment: _ If one disperses only the Luomai, the Yang energy escapes and Zhong Qi (“center” energy), being in insufficiency, the disease is difficult to cure.

5 - “Well-balanced Yin-Yang” Type a) Behavior: _ calm and well-balanced life _ does not feel anxious and does not chase after pleasures _ conciliatory spirit _ modest despite high placed position _ uses virtue to convince and laws to administer (like the effective method to “govern” the country). b) Constitution: _ Yin and Yang energies are balanced _ Blood and vessels (energetic) are harmonious.

c) External Morphology: _ calm and level-headed appearance _ scrupulous and serious attitude _ benevolent and reflective air (4). d) Treatment: _ carefully determine Yin and Yang and discern emptiness and fullness of the perverse energy and essential energy _ disperse fullness and tonify emptiness _ in the event of absence of emptiness or fullness, treatment must be carried out as a function of the channels. 4. In Chinese terminology, it is what one calls “the sage”. no 324/325.

CHAPTER

LXXIII

Ability in the Practice of Acupuncture 266

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(Guan Neng)

Chapter 73 of the Lingshu speaks on the theoretical and practical problems of acupuncture linked to knowledge of: _ the relationship between Xing (form) and Qi (energy), _ the localizations “Top/Bottom, Left/Right, Yin/Yang and Interior/Exterior”, _ the abundance or shortage of Blood and Energy of the Jingmai, _ the “favorable/contrary” circulation _ and the movements “reunion/meeting, entry/exit” of the energy and on the therapeutic problems posed by: _ the properties of the Wu Shu (5 Shu-antique points: Jing, Ying, Shu, Jing and He) under the permanent influence of Yin and Yang, the 5 Movements, 4 Seasons, 8 Feng (winds) and 5 Organs/6 Bowels, _ observation of the colors of the face, _ the characteristics of the disease: Interior/Exterior, Cold/Heat, Emptiness/ Fullness _ and the choice of points in order to practice acupuncture or moxabustion. • Moxabustion is precisely indicated in diseases caused by “Great Cold” in the interior and by concomitant emptiness of Yin and Yang. • Tonification must be applied according to the technique known as “square” ( ), and dispersion according to the technique known as “round” ( ); therapeutic efficacy depends on this. Finally, the last paragraph of this chapter addreses the problem of the initiation of nurses, acupuncturists, masseurs and therapists by invocations and meditations from antiquity. This chapter contains 5 paragraphs.

PARAGRAPH 1

326.

Huangdi, questioning Qi Bo, declares: “After having listened many a time to your teachings on the role of the “9 N e e d l e s ” , I had been able to appreciate the immensity of their clinical importance. I have attempted to go deeply into it and make a synthesis. I would like to submit my work to the Master so that he may deign to correct it and model in after the Dao (of Acupuncture). To those whose spirit merits it, we will teach it to them; otherwise, we will refrain from it.” Qi Bo:

“Your subject is ready to hear the Dao of Acupuncture as formulated by His Majesty.” Huangdi: “The practice of acupuncture is

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_ the precise knowledge of anatomic regions (Xing = form) and energetic regions (Qi = energy) and top/bottom and left/right regions of the body, _ the determination of Yin and Yang, Biao (exterior) and Li (interior), the abundance and shortage of Xue (Blood), the contrary/ favorable circulation and the sites of entry/exit of the energy (Qi), _ the comprehension of the rules of protection against perverse energy and its elimination, without neglecting eugenism, _ the discernment of the principles of liberation of accumulations (energetic) and techniques of tonification in the event of emptiness and dispersion in the event of fullness, _ The identification of the doors of the energy (Qi Men) located above and below (the channels of the hand are above and those of the foot are below; the sites of entry/exit of the energy are named “ d o o r s ” ) , _ the knowledge of the role of the “4 Seas” (Sea of Energy, Sea of Blood, Sea of Marrows and Sea of Cereals), _ the determination of the localization of the Cold and Heat energy and site of their progression, _ the differentiation of emptiness and fullness of the Jingmai and Luomai disseminated to the left and right of the body as well as the sites of their Reunion/Meeting. Furthermore, _ in the event of confrontation of Cold and Heat, one must know how to associate them to Yin and Yang to regulate them; _ in the event of equality of Emptiness and Fullness, one must know how to base one’s judgment on the insufficient and excessive states of the Jingmai in order to aerate them; 327. _ In the event of penetration of perverse energy into the Great Luo of the left, the disease becomes triggered at the right, and vice versa; one must know how to use the technique known as needling on the opposite side (Mu Ci). Finally, it is necesary to go deeply into: _ the reason of contrary and favorable in order to be able to judge the opportunity to treat in the favorable case and the pointlessness of treating in the contrary case; _ the determination of the Summit (Jiao) and Root (Ben) in order to resolve the evolutive process of perverse energy and identify the location of the disease. In this manner, to possesses all these notions is to master clinical practice and grasp the functions of the “9 Needles” ; this is to follow the Dao of needling.”

EXPLANATIONS AND COMMENTARIES N.V.N.: 1. Here, the term Qi Men (“door of the energy”) (1) designates the energetic point, site of entry/exit and arrival/departure of the energy of the Jingmai. The study of energetic points (Chapter 58 of the Suwen,“Study on the Energetic Points”) is of such importance that Huangdi has ordered his ministers to colliger all the works on this subject into the Linglan Palace under the title: “Locations of the Energetic Points”.

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Qi Men (“door of the energy”) had also been mentioned in Paragraph 9 of Chapter 3 of the Suwen (“Relationship of the Vital Energy to that of Heaven”): “ ...during the day, the Yang energy of the body protects the exterior. At dawn, it begins to be produced; at noon, it is at full strength; in the evening, it grows weaker, the doors of the energy begin to close. When the Yang energy enters within the Yin part, the doors of the energy close up even more. Also, during the night, it is necessary to let this energy rest and be put under cover and the doors of the energy properly be closed up; do not use the muscles and bones, do not become open to white frost. Any violation of these rules of the evolution of the Yang energy during these 3 periods of the day incite attack by perverse energy; the organism will be therefore weakened.” It should be noted that the term Qi Men cited in this paragraph has a different meaning from that found in the Suwen. In effect, Wang Bing defined it as “sweat gland holes” (2). 328.

2. According to the Lingshu (3), the “4 Seas” are the following: _ the stomach is the “Sea of Shui Gu” (Cereal Water). Its Shu point of the top is Qijie (St 30- Qichong) and that of the bottom is ZuSanli (St 36). _ the Chongmai is the “Sea of Blood” of the 12 channels. Its Shu point of the top is Dazhu (Bl 11) and that of the bottom the points Shanglian (St 37) and Xianlian (St 39). _ Tanzhong (CV 17) is the “Sea of the Energy”. Its Shu point of the top is found at the top and bottom of Zhu Gu (the cervical vertebrae) (4); that of the bottom is Renying (St 9). 1. One had to await 1970 for the word “door” (in English: “gate”) to again be used by Malzack and Wall (“Gate Control Theory”) in their theory on the mechanism of pain.√ 2. Cf. Suwen, Volume I, N.V.N. Edition. 3. Cf. Lingshu, Chapter 33 (“Study of the Seas”), Volume II, N.V.N. edition. 4. According to Ma Shi (see Lingshu, Volume II, Chapter 33, footnote 3, page 177, JTS Productions edition), the top and bottom of the cervical spine designate the points Yamen (GV 15) and Dazhui (GV 14).

_ The brain is the “Sea of Marrows”. Its Shu point of the top is Baihui (GV 20) and that of the bottom is Fengfu (GV 16).

3. In relation to “needling on the opposite side” (Mu Ci), Qi Bo explains it in this way (5): “When guest perverse energy infiltrates into the organism, it settles first in the pilocutaneous system. From there, it spreads or it takes the paths of the Sunluo (little Luo). From the Sunluo, it spreads or reaches the Luomai (secondary vessels). From the Luomai, it spreads or penetrates into the Jingmai (principal channels) linked to the 5 organs. From the Jingmai, it invades the stomach and intestines. Yin and Yang are therefore attacked and the 5 organs are injured. In short, the different phases of penetration of perverse energy into the organism concern, in the first place, the pilocutaneous system and, in the last place, the 5 organs. In this case, one must treat the Jing (principal channels). This is the method of “Great Needling” of Ju needling. But in the case where the guest energy arriving at the Sunluo is blocked at this level, without possibility of reaching the Jingmai, it becomes directed into the Dailuo (6) (Great Luo) provoking the singular diseases (7). Settled within the Dailuo of the left side, it flows out toward the right side, and settled at the right side, it flows out toward the left side. It spreads out therefore into all parts (Top/Bottom, Left/Right) into the energetic routes by which it diffuses into the 4 limbs. This guest energy is not fixed and cannot penetrate into the Shu points of the principal channels. This is why one must employ the method of “needling on the opposite side”.” Treatment consists of needling the Jing-well point, 1st Shu-antique point of the principal channel), corresponding to the opposite Dailuo.

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4. According to Zhang Jing Yue, the identification of “Summit” (Jiao) and “Root (Ben) is done at the level of the pulses.

5. Cf. Suwen, Chapter 63 (“Discourse on Needling on the Opposite Side”), N.V.N. Edition. 6. According to Wu Gong: “The Dailuo are the principal branches of the 12 channels”. In other words, for him, they designate the secondary vessels (tendinomuscular, distinct, curious, longitudinal Luo, transversal Luo,...). For Pienn Tsio, it concerned only the 15 Longitudinal Luo. 7. According to Zhang Jing Yue: “The “singular” diseases cited in this paragraph are those of the Dailuo and not of the Jing.

PARAGRAPH 2

329.

“1. Knowledge of the role of the “5 Shu (antique) points” permits utilizing the technique of tonification and dispersion consisting of transmitting slow or rapid movements to the needle. 2. The Jing Qi (energy of the channels) circulates in bending and s t r a i g h t e n i n g √ or entering and exiting in accord with very specific rules. 3. Yin and Y a n g (of man) coordinate the 5 Movements. The 5 organs and 6 bowels are endowed with functions responding to these 5 Movements and to Yin and Yang. 4. The 4 seasons and “8 Cardinal Points” or “Ba Feng” (4 cardinal points + Northeast, Not=rthwest, Southeast and Southwest), belonging to Yin and Yang (of Heaven), have influence on the human being each part of which possesses the same characteristics manifesting at Mintang (nose). Mingtang is therefore the site of manifestation of the pathologic states of the 5 organs and 6 bowels and the site of appearance of the colors of the 5 organs involved. As a result, during the examination of the effected organs, study attentive to the colors associated at the top or bottom, to the left or right, of the face permit determination of disease associated with Cold or Heat and manifesting at the level of the channels. Therefore, after having evaluated the characteristics of the Cold and Heat and their slippery (Hua) or rough (Se) state, one can diagnose the degree of seriousness of the disease.

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5. Due to the diaphragm separating the body into upper and lower parts, one can easily determine the location of the disease. First, one pinpoints the paths of the Jingmai before selecting the points, then one uses the method of deep needling with the needle left in place in order to aid the vital (essential) energy to rereach its circulatory path in the goal of countering the perverse energy. If heat is lodged in the upper part of the body, the method consists of transmitting propulsion movements to the needle allowing immobilization of the heat to attract it toward the bottom; likewise, if the perverse energy ascends from the bottom upward, the same method makes it descend. In all cases, one must attention to the previous localization of the pain (that one disperses at the level of local points). 6. In diseases that do not respond to acupuncture, one must practice moxabustion. In the event of insufficiency of the energy at the top, one must push the energy toward the top (by the method of propulsion cited above) to tonify the top, and in the event of insufficiency of the energy of the bottom, one must leave the needle in place until the arrival of the energy (De Qi) to refill the bottom. 330.

In the event of concomitant insufficiency of Yin and Yang, one should only use moxabustion. In diseases of contrary afflux (Jue Ni), with appearance of signs of cold such as muscular weakness (atrophy) with ice cold limbs up to the knee, one should apply moxa to the points Xialian (St 39) and Sanli (St 36). In stagnation of perverse cold at the level of the passages of the Luo Yin or at the level of the organs (via the path of the Luo Yin), one must use the method of propulsion to chase out the perverse cold. In contrast, if the stagnation of cold occurs at the level of the Jingmai (principal channels), one should use moxabustion. Similarly, if the stagnation of the Luomai present in the form of hard trajectories, one should also prescribe moxabustion. site the the The

7. In pains without fixed location, one should choose the point Zhaohai (Ki 6), of departure of the Yinqiao, or the point Shenmai (Bl 62), site of departure of Yangqiao. In men, use the Yangqiao, and in women, the Yinqiao. If one treats Yinqiao in men and the Yangqiao in women, one obtains a contrary reaction. good physician does not commit this error. Such are the key and sufficient components in the practice of acupuncture.”

EXPLANATIONS AND COMMENTARIES I - Ma Shi explains:

“a- The 5 organs each possess Jing, Ying, Shu, Jing and He points grouped under the name “Wu Shu” (5 Shu-antique points). The 6 bowels also possess Jing, Ying, Shu, Yuan, Jing and He points grouped nder the name “Lu Shu” (6 Shu-antique points) among which the Shu and Yuan points open at the same time. b- “Techniques of tonification and dispersion...” refers to Chapter 3 (“Explanations of the Little Needles”) of this classic. c- “The Jing Qi (energy of the channels) circulates in bending and straightening...” refers to Chapter 71

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(“Cold-Heat”) of this classic. d- “The 4 seasons and 8 cardinal points (Ba Feng = 8 winds or directions)...” implies that the Celestial Dao (natural world) also possesses Yin and Yang and 5 movements. Refer to Chapter 77 (“9 Palaces-8 Winds”) of this classic. e- “Mingtang (nose) is the site of manifestation of the pathophysiologic states of the 5 organs...”. Refer to Chapter 49 (“The Five Colors”) of this classic. 331. f- “The diaphragm possesses top and bottom...”. The lung and heart are located in the upper zone; the spllen, in the “central” zone; and the liver and kidney, in the lower zone. This division permits the determination of the sites of disturbance of the energy of the 5 organs. One must delve deeply into the trajectory of the Jingmai before selecting the points to needle.” g- In the event of simutlaneous emptiness of Yin and Yang, acupuncture is strictly forbidden and moxabustion is strongly recommended. h- “Xialian (St 39) and Sanli (St 36)...”. Here, hese two points designate Sanli (St 36).” II - Znag Shi states:

“To leave the needle in place and await the arrival of the Yang energy is to leave the needle on the spot until the arrival of heat at the point of the needle. This technique always is aimed at tonifying the Yang of the body to combat perverse cold. The He point (6th Shu-antique point) is suitable for treatment of the bowels. It is aimed at expelling the perverse cold and perverse heat etiology of the disease.” III - N.V.N.: Zhang Jing Yue furnishes us with the following iinformation: “Warm skin and cold skin, smooth skin and rough skin are diagnostic components allowing determination of cold or heat etiologies of the disease. One transmits movements of propulsion to the needle to tonify the upper (superficial) zone, and one leaves the needle in place to increase the energetic potential of the lower (deep) zone. Generally, stagnation of perverse cold into the interdermal-dermal and inter-arterial spaces does not cause fixed location. As a result, one should apply moxas to the Yangqiao in men and to the Yinqiao in women.” (8)

PARAGRAPH 3 “During the practice of acupuncture, one must scrupulously respect the rules. Above, one must know how to observe the Celestial Lights (sun, moon, stars...), and down below, to determine the evolutive principles of the Ba Sheng (8 energetic divisions of the year or, more exactly, 8 astronomic rhythms) in order to avoid the disordered perverse energy of the 4 seasons. One must also know clearly the foundation of the Wu Lun (5 social ties) ( 9 ) of the 100 families and also discern well the

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True Winds and Perverse Winds in order to better understand other pernicious energies. Therefore, in failing to recognize diseases duet to wind or disordered energy of the 8 Sheng of the year, the physician worsens the disease. As a result, it is necessary to delve deeply into the favorable and contrary phenomena of the 4 seasons before addressing the problem with the practice of acupuncture.

8. Consult Chapter 17 (“Measurement of the Vessels”) (Lingshu, Vol. I, p. 429, JTS Productions Ed.). 9. According to Confusian moral/ethics√, the 5 social ties are: _ between king and subject _ between father and son _ between brother and sister _ between husband and wife _ between friends.

It is also necessary to carefully explore the experiences of our ancient masters in order to adapt them to current circumstances. Therefore, to master in depth what occurs in the interior of our bodies, such as the circulation of Ying (nutritive energy) and Wei (defensive energy), Xue (blood) and Qi (energy) is the primary condition to transmit the traditions to posterity. Modifications and transformations are very important and subtle problems that poor physicians ignore and good physicians llok after like precious objects. These do not present themselves in material or visible form; they manifest like Shen Qi (mental energy), at once present and absent.”

EXPLANATIONS AND COMMENTARIES N.V.N.: 1 - The “rules of practice” of acupuncture ar also described in Chapter 26 of the Suwen (“Incidence of the 8 Principal Rhythms on Human Energy”) where we read: Huangdi: “What are the principles governing the practice of acupuncture?” Qi Bo: “One must know the laws of Heaven and Earth and procede conforming to the principles that govern astronomic phenomena. In effect, the sun, moon, stars, 4 seasons and 8 principle astronomic rhythms (Ba Sheng) exercise an influence over human energy that should be evaluated before putting acupuncture to work. When the weather is beautiful and mild, blood is more fluid, defensive (Wei) energy rises to the surface, blood flows out freely and the energy circulates easily. When it is cold and gloomy, blood has a tendency to stagnate and the energy to sink down. 333.

At the new moon, blood and energy begin to become pruified, the defensive energy,

to flow

out. At the full moon, blood and energy are in abundance, the muscle become firm. When the moon is waning, the muscle become lax, the secondary channels and empty, defensive energy becomes dispersed, the container no longer adapts to the contents√; this is why the balancing of blood and energy must be based on the study of

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vessels

Celestial phenomena. In principle, _ one should not needle when it is very cold, _ one should needle when it is warm, _ it is recommended: • not to disperse at the new moon • not to tonify at the full moon • not to needle during the waning moon. These fundamental rules assure energetic reequilibration at the optimal time. They follow the knowledge: _ of the order of nature, _ the extreme states of emptiness and fullness between which natural phenomena and the progress of stars oscillate, in a word, of the knowledge of astronomic phenomena. In this manner, at the new moon, dispersion could weaken the internal organs. During the full moon, tonification risks bringing about an increase in blood and energetic mass and a stasis of blood in the secondary vessels; all of these phenomena results in what one calls a “superimposition of fullnesses”. During the waning of the moon, needling provokes disturbances of the vital energy also called disturbances of the channels. These disturbances could be due to the fusion of Yin and Yang energies, to the mixture of essential and perverse energies or to the deficiency of Yang energy at the exterior and the perturbation of Yin energy in the interior. Their essential characteristic is the tendency to become worse.”

2 - The Ba Sheng (8 principal astronomic rhythms = 8 energetic divisions of the year) are: _ the 2 equinoxes: • spring equinox • autumn equinox 334. _ the 2 solstices: • summer solstice • winter solstice _ the 4 beginnings: • beginning of spring • beginning of summer • beginning of autumn • beginning of winter.

3 - “Carefully explore the experiences of our ancient masters...” In the same Chapter 26 of Suwen (“Incidence of the 8 Principal Rhythms on Human Energy”), we read: Huangdi: “Now that I know the influence of Celestial phenomena on human energy, I would like to know how to imitate the Ancients? Qi Bo: “In order to follow the examples of the Ancients, it is necessary first to know the classic book of acupuncture and then to put into practice the aqcuired notions. The necessity to adopt treatment as a function of the timestemps, phases of the moon and climatic fluctuations is one of the essential conditions to assure therapeutic effectiveness. The power of the “confused and humbleoscure” observer” is the indispensible factor in

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establishing an early diagnosis. In this manner, the physician must be able to grasp the subclinical disturbances of the organism by sole observation of the state of the defensive energy. The collation of physical signs gathered via observation and the determination of their correlation with cosmic phenomena, the times, lunar month and climate, allow establishing the proper treatment. As a general rule, the physician must diagnose the illness in its latent phase, at the time when it is still devoid of any clinical expression. This is why one says that one can observe the genuinereel through confused and complex appearances; it is this acute sense of observation matched with long experience that can direct the acquisition of new truths worthy of being transmitted to posterity. These two qualities moreover permit the establishment of a heirarchy among physicians. At the true starting phase, by reason of the absence of any clinical manifestation, the illness appears as something invisible, insipid, dissolved within darkness. Only a spirit endowed with the “vision of the invisible” can penetrate these phenomena.”

PARAGRAPH 4

335.

1- When perverse energy attcks man in a state of weakness or emptiness, it causes chills. When the True Perverse (“Cheng Xia”) attacks man in a state of sweating during physical effort, the illness is slight; it manifests at the face by a change in color. In this case, the individual has the feeling: _ of being ill, then he is not _ of being cured while he is always ill _ of having an unhealthy look while he carries no illness. Therefore, it is not easy to define the pathologic state of the patient. The good physician against this perverse energy in treating as soon as it manifests, while the poor physician only intervenes once the illness is in full evolution, worsening it. 2_ _ _ _ _

This is why the physician, skillfully using the needles, knows perfectly: the localization of the energy in order to monitor its doors of entry and exit the method of regulating the blood and energy the times of tonification and dispersion the meaning of slow and rapid needling and the principles of the choice of points.

In dispersion, he maneuvers the needle with his dexterity, transmitting to the needle rapid, rotating movement as a function of the state of the llness, to evacuate the perverse energy and recuperate the essential (vital) energy. The implantation of the needle must be rapid and removal slow. This maneuver imposes the perverse energy to follow the movements of the needle to be eliminated. If one uses the method of “Meeting/Pursuit” to disperse, one must stir r e m u e r the needle in order to enlarge the point of impact in order to facilitate the expulsion of the perverse energy. In tonification, one massages the skin lightly with the left hand at the level of the point chosen, and with the right hand applies pressure on the point of impact and slowly inserts the needle. This maneuver is executed with calm and ease; then, with flexibility, one leaves the needle in place until the regulation of the energy before removing it rapidly. Immediately upon removal of the needle,

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one obsturcts the point of impact. This maneuver avoids the elimination of the vital energy. 336. Qi

The essential fact in use of needles is not to neglect the problem of the Shen (mental energy).”

EXPLANATIONS AND COMMENTARIES N.V.N.: 1- Regarding the “true perverse energy”, the following explanation is found in the Suwen (Chapter 26 (“Incidence of the 8 Rhythms on Human Energy”)): “One distinguishes two disruptive forces: _ Xu Xia or “disruptive force acting on the organism in a state of emptiness” which is represented by the perverse energy of the 4 seasons and 8 principal astronomic rhythms _ Cheng Xia or “disruptive force acting on the organism in apparent good health”. It attacks the body as it perspires, when it is exposed to wind after intense physical effort, while the sweal gland orifices are still wide open. The lesions provoked by this latter disruptive force are usually transient and benign; therefore they often occur to physicians who do not know their nature and do not have the ability to link them to their true cause.

2- Regarding “physicians”, also in Chapter 26 of the Suwen, Qi Bo gives us his opinion: “The superior physician (Shang Gong) treats the disease before its apparent start, at the time when the energy of the “Three Regions and Nine Places√” is still maintained in a state of equilibrium and has yet to present signs of deficiency. The inferior physician (Xia Gong) treats the disease when already present because he does not know how to recognize the interrelationships between the “Three Regions and Nine Places√” and, therefore, allows it to evolve. In order to determine the cause of the disease and specify it or the channels affected, it is necessary to base the examination of the pulses and exploration of the “Three regions and Nine Places√”. This is why on says that to penetrate the intimate mechanism of the “Three Regions and Nine Places” is to permanently guard the door in total security√. As a result, the great physician can immediately discern,√ enigmatic and imperceptible signs for others, any aggression coming from the exterior in order to curb it and prevent it. Recall that the “Three Regions and Nine Places/?Centers/Environmentslieux” are divided between “Heaven-Earth-Man” (see the following table).

3- The precise definition of the terms “tonification” and “dispersion” is given in the Suwen (Chapter 26): Huangdi: “ I have heard something about tonification and dispersion and have not clearly grasped their meaning.” Qi Bo: “For dispersion, one must know how to master the method Feng (square) which gives us the time and manner to do it. One should disperse when: _ the energy is in full effervescence _ the moon is full _ the sun begins to heat up the Earth _ the organism is in a state of stable equilibrium. And one should:

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_ stick the needle in during inspiration _ turn it during the next inspiration _ and remove it slowly during expiration. The application of the Feng technique allows optimal dispersion, that is to say, allows all perverse energy to be expelled and regulates the energetic circulation. For tonification, one must know how to master the technique Yuan (round): theoretically, it consists of mobilizing the energy and channeling it toward the ill region. Practically, one must stick right in the center of the Ying points and remove the needle during inspiration. The terms Yuan (round) and Feng (square) do not involve the shape of the needles; it evokes the necessity of applying the treatment as a function of the constitution (obese or thin) of the individual, the state of emptiness and fullness of the energy and blood because energy and blood are precious things one must look after”. 337.

Regions

Upper (Heaven)

Middle (Earth)

Centers lieux Upper (Heaven)

temporal part of Foot Shaoyang (GB)

Middle (Earth)

facial (cheek) portion of Foot Yangming (St)

Lower (Man)

auricular portion of Hand Shaoyang (SJ 21)

Upper (Heaven)

Hand Taiyin (Lu) at the point Taiyuan (Lu 9)

Middle (Earth)

Hand Yangming (LI) at the point Hegu (LI 4)

Lower (Man)

Upper (Heaven) Lower (Man)

Relationships

Middle (Earth) Lower (Man)

Hand Shaoyin (He) at the point Shenmen (He 7)

Foot Jueyin (Li) at the point Taichong (Li 3) in women and Jimai (Li 12) in men Foot Shaoyin (Ki) at the point Taixi (Ki 3) Foot Taiyin (Sp) at the point Jimen (Sp 11) or Foot Yangming (St) at the point Chongyang (St 42)

Then from Chapter 27 of the Suwen (“Separation and Reunion of Pure Energy and Perverse Energy”), Qi Bo adds: “a- great physicians, before adopting treatment, must necessarily observe the evolutions of the natural world: _ in Heaven, there are sidereal degrees _ in Earth, there are courses of water _ in Man, there are Jingmai. 338.

These components have a mutual effect that can be compared and analyzed.

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_ When the energy of Heaven and that of Earth are moderate, the courses of water are slow and peaceful. _ When the energy of Heaven is cold and that of Earth iced over, water freezes and transforms into ice. _ When the energy of Heaven is red-hot and that of Earth hot, the courses of water reach the boiling point. It is the same for the penetration of perverse energy. _ If it involves Cold, blood freezes. _ If it involves Heat, blood and energy heat up. _ If it involves Wind profiting from the insufficiency of the body, the Jingmai become stirred and rebound√ like a course of water under the effect of a thunderstorm. At Cun Kou (wrist pulse), the pulsations are strong or weak: _ weak when the perverse energy flows afflue, _ strong when the perverse energy is calm and passes without settling. If at Cun Kou the disease cannot be localized either at Yin or Yang, one should very carefully examine the “3 Regions 9 Places√”. As soon as it is localized, one must rapidly treat to curb its evolution. Treatment consists of: _ pushing the needle in well during inspiration to prevent the ascent of the energy _ leave it in place a moment to prevent the perverse energy from spreading _ turn it during inspiration with the goal of obtaining De Qi (arrival of the energy) _ wait to gradually remove it and completely lift it out at the end of expiration. Acting in this way, the perverse energy will be totally dispersed toward the exterior, that is to say, what one calls “dispersion”.

b- And in order to tonify insufficiencies, initially: _ palpate and massage the point to obtain cutaneous dilation _ apply pressure on the point and press to spread the energy _ make a flicking motion there to concentrate the attention of the patient on the point then _ press well on the point and needle it _ leave the needle in place a moment _ at the arrival of the energy, remove it with the right hand and close the opening off with the left hand to prevent it from escaping. The essential technique of needling can be summarized in this manner: 339. _ push the needle in well at the end of expiration, _ leave the needle in place a moment to obtain De Qi, _ calmly wait for the arrival of the energy like one waits for an honored guest without becoming preoccupied with the time that passes, _ as soon as the needle is removed, press on and masage the opening in such a way as to conserve the mental energy. Acting in this manner, the great energy is conserved within the channel; it will then circulate with the Ying (nutritive) energy and Wei (defensive) energy, that is to say, what one calls “tonification”.”

4- Regarding the Shen (mental) “which one must not neglect”, Qi Bo gives us the following explanations (Chapter

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26 of the Suwen): Huangdi: “Marvelous account! No one but you can grasp the relationships between Man and Yin-Yang, Emptiness and Fullness and the complexity of biologic phenomena. But you often speak of Xing (form) and Shen (mental). What do you mean by that?” Qi Bo: “Form is the power to grasp morphologic, structural, invisible modifications based on questioning and examination of the pulses. The combination of these two methods of diagnosis permit visualization of the morbid process because it is impossible to establish a diagnosis of certitude when one of the essential signs cannot be detected and integrated into a whole. The Mental is the power to grasp directly, immediately by simple inspection without having to resort to questioning. In the final analysis, it is the capacity to instantly interpret phenomena by a movement of extremely rapid thought and penetrate the interior of an object to grasp what is unique, and consequently, inexpressible, about it√. It is like light which flashes out of the darkness, the wind that chases away the clouds. This sudden illumination permits seeing at once what escapes others. This is why one calls it “Mental”. Direct vision of the intimate mechanisms of the “3 Regions and Nine Places√” by the Mental radiatesdispenser the application of the principles of the “9 Needles”. For us, the Shen described in this Chpater 72 of the Lingshu does not designate the power to directly grasp facts by simple inspection, but by the Jing (anatomic, sensorial, psychologic,...) of the 5 organs.

PARAGRAPH 5

340.

Leigong questions Huangdi: “The Zhen Lun (Discussion on Needles) that His Majesty comes to evoke states: “We only teach acupuncture to those predisposed to this art”. How do you define this ability?” Huangdi: “One must impart to each a specialty in teaching him according to his capacity so that he can assume his work with competence”. Leigong: “Your subject wishes to hear the teaching of the abilities of practice.” Huangdi: “We will teach: _ the way of observing colors to those who have clear-sighted vision _ the way of hearing sounds (of the voice) to those who have keen hearing _ the way of expressing thought to those who have noble and academic language and well-articulated speech _ the way of manipulating needles and moxa to those who have easy and measured tone of voice, easy gait, skillful actions and a heart full of judgment so that they can aerate the blood and energy, regulate the contrary and favorable, observe the phenomena of transformation of Yin and Yang, and, finally, deepen the therapeutic methods _ the way of massage to direct the energy to those who have supple and fluid hands, excellent muscular force and peaceful heart

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_ the way of using magic words (invocation: Zhu Wu) to treat illnesses to those who have a regular jealous nature√ to hold impertinent and hard words _ and the way of palpating and kneading/shaping√ masses (energetic and blood: stasis) and chronic Bi (paresthetic) illnesses to those who have clumsy hands and who commit blunders in repetitive fashion. Each has, therefore, a specialty responding to his abilities. Thanks to this, therapeutic methods are awarded success and the reappointment of practitioners transcends boundaries√ . In conclusion, acupuncture is an art that can only be transmitted to those who are likely to follow it; one can easily verify this by the following method: 341.

_ Take a tortoise and place it in washtub. _ Ask the subject concerned to press strongly on the carapace of the animal. If the subject has a malign hand, the animal dies in 50 days; the medical profession ( 1 0 ) is therefore not recommended. In contrast, if the hand is beneficent, the animal remains alive; the medical profession is recommended.”

EXPLANATIONS AND COMMENTARIES N.V.N.: Each individual has an ability or gift which is proper to him and is necessary to make use of in order to draw out the best in him. In this paragraph, Huangdi gives criteria n the personality of the practitioner in the choice of his specialty or orientation. 1- “Magic words (invocations or “Zhu Wu”)”: information on this technique, similar to a type of ancient psychotherapy, has been given in Chapter 58 of this classic (“Pirate-Wind”). 2- “... art only able to be transmitted to those who are apt to follow it”. Chapter 69 of the Suwen (“Great Discourse on the Energetic Exchanges and Their Alterations”) has also spoken about the problem of the perpetuation of knowledge by teaching reserved for worthy people: Huangdi: “I have heard something about: _ without teachings by the learned, cultural transmission is lost. This is the end of the Dao, _ if one transmits them to unworthy people, one considers educational training to be slight and one becomes engaged in irresponsibilty. My knowledge being imperfect, I cannot assume this cultural transmission to future generations. But my people are affected by numerous fatal illnesses; I therefore implore you, dear master, in the name of the nation, to explain this to me. As for the transmission to future generations, I will charge myself to execute it according to your teachings. What do you think?”

10. The “medical profession” of Huandgi’s era included physicians, physician’s aids (nurses), masseurs and invocators (ancient psychologists).

Qi Bo: “I am going to try to explain it to you precisely. In effect, according to Shang Jing: “The Dao of medical research consists of the knowledge of the Top (astronomy), Bottom (geography) and Middle (human affairs). This is the sole means of preserving it for a long time. Such is the reason for the Dao of Medicine.”

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Huangdi: “What is its meaning?” 342. Qi Bo: “The Dao of Medicine consists of determining and comprehending the localization of the 3 energies, that of Heaven, Earth and Man. The detremination of the localization of the energy of Heaven (Tian Qi) involves astronomy. The determination of the localization of the energy of Earth (Di Qi) involves geography. The comprehension of the modification-transformation of the energy of Man (Ren Qi) involves human affairs. The energy in an excessive state is that which comes before seasonal climatic energy, and the energy in an insufficient state is that which comes after climatic energy. This is why it is said: “The circumductions of Heaven and Earth, to which respond energetic activitities, are rational and normal, modified or altered...”.”

3- The method of “the hand pressing on the back of the tortoise” was derived from the obvious inherent superstitious beliefs of the era of high antiquity. It was therefore supposed to acknowledge good physicians and nurses. Zhang Jing Yue (163-1640 A.D.) states regarding this: “The tortoise activates the circulation of the Renmai (CV). It respires via its ears and, therefore, can redirect deeply concealed energy toward the surface. Therefore, the tortoise is considered a very sacred animal; its longevity is known. In Antiquity, our ancient masters utilized it to detect the cruel and harmful hands of the human being.” This reptile enters into the greatest Oriental myths because it is the animal representation of the universe. Its carapace, square at the bottom, round at the top (like Earth and Heaven), was considered the image of the world and the divine read predictions from it.

343.

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CHAPTER

LXXIV

Dissertation on Diseases and the Examination of the Skin of the Forearm (Lun Xi Zhan Chi)

Chapter 74 of the Lingshu speaks on the examination of “Chi Fu” (skin of the forearm) in the determination of the energetic state of the 5 organs and the evolutive process of diseases. It consists of 5 paragraphs: 1- States of the skin of Chi Fu and diagnosis of diseases: edema, muscular atrophy, algoparesthesia, anasarca... . 2- States of the skin of the elbow, dorsal face and palm of the hand and the determination of diseases localizing in the supra- and infra-lumbar, thoracic, scapulo-dorsal... regions. 3- States of the skin of Chi Fu and the prognosis of recent hemorrhage and certain death. Examination of the eyes and the determination of the diseases of the 5 organs and ocular diseases. Signs of icterus. 4- The pulse in pregnancy. Evaluation of the seriousness of fetal diseases. 5- The transformation of Yin and Yang, cold and heat.

PARAGRAPH 1 Huangdi: “I think that the examination of the colors and pulses is not necessary because observation of the state of the Chi Fu region (skin of the forearm, that is to say, the skin between the “ C h i ” pulse and the elbow) is sufficient to determine the type of disease. This method consists of oberving the exterior to define to the interior. How do you succeed in this?” 344.

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Qi Bo:

“Initially, one should clearly assess the slow or rapid, large or small, slipperty or rough nature of the “ C h i ” (foot) pulse, then evaluate the state of firmness or suppleness of the flesh system of the region of Chi Fu in order to diagnose the type of disease. In

this

manner,

for

example,

during

the

examination,

1 - If the individual presents signs such as: _ subocular swelling as during sleep _ agitated carotid pulse _ frequent cough _ and impression left after finger pressure ( 1 ) these are signs revealing the disease of Feng Shui (edema of ”Wind-Water” etiology). 2 - If the skin of Chi Fu is slippery, smooth and velvety, this is F e n g disease (Wind). 3 - If the skin and muscles of Chi Fu are flaccid and diminished in volume, this is Ji Jie (atrophy). 4 - If the individual is sleepy both day and night with extreme weight loss, the disease belongs to the incurable group of Han Re ( C o l d - H e a t ) . 5 - If the skin of Chi Fu is slippery like grease, this is the F e n g (Wind) disease. 6 - If the skin of Chi Fu is rough, this is the Feng Bi caused by Wind).

disease

(algoparesthesia

7 - If the skin of Chi Fu is warty like the dry scales of a fish, this is the overflowing of “Humidity-Water” up to the feet and hands (anasarca). 8 - If the skin of Chi Fu is burning hot with the pulse in great fullness, this is the W e n disease (“Moderate Heat”).

1. Literally, one says “making the sign of “pitting””.

9 - If the pulse is slippery and full, this is the sign indicating the i m m i n e n t / r e c e n t √ p r o c h e exteriorization of the energy (heat), indicator favorable of cure. or

10 - If the skin of Chi Fu is cold with small pulse, this is the sign of diarrhea excessive emptiness of the energy (asthenia). 345.

11 - If the skin of Chi Fu is burning hot as against a flame, first hot then cold, this is the disease of “Cold-Heat” (Han Re). 12 - If the skin of Chi Fu is first cold and the cold stays some time not b e c o m i n g avant que ne vienne heat, this also the disease of Cold-Heat.”

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EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains: “1- The foot Taiyang (Bl) starts at the internal canthus of the eye, ascends the forehead, descends to the cervical region... . The Taiyang governs Cold-Water and its energy circulates within the external region of the body. Water of Taiyang follows the energy and flows out into the pilocutaneous region which causes subocular swelling always accompanied by agitation of the carotid pulse and edema of the skin. In this case, cough is frequent because Water stagnates at the level of the skin and the skin is linked to the lung.

2- The disease of Feng Shui (edema of Wind-Water etiology) is due to the infiltration of Wind energy into the pilocutaneous layer. When Wind circulates, Water follows it and provokes edema (of Wind-Water origin, Feng Shui). 3- Smooth and slippery skin comes from the disturbance of organic liquid caused by Wind (Feng).”

II - N.V.N.: 1. Regarding Feng Shui (edema of Wind-Water origin), Chapter 4 of this classic (“Pathologic forms of Attack of the Organs and Bowels”) is important to recall. Huangdi: “What is the cause of the disease of Feng Shui (Wind-Water)?” Qi Bo: “Perverse energy floods where there is emptiness of the energy. The kidney organ is Yin, perverse wind is Yang. Yin being in empitness, Yang benefits from this emptiness to trigger hypopnea with fever, sweating and red symptoms signal an attack of the lower abdomen by heat. The dorsal decubitus position os impossible due to the dysharmony of the energy of the stomach. Worsening of the cough by the dorsal decubitus position is due to an afflux of “Water” energy (Shui Qi). In a general way, the disease of “Shui Qi” always starts with edema of the eyes.” Huangdi: “Why?” 346. Qi Bo: “Water is Yin; the area under the eyes is also Yin; the abdomen is the site of Zhiyin (arrival of Yin). Therefore, Water within the abdomen always causes subocular swelling. The flooding (afflux) of the energy of the heart toward the top is perceived by the bitterness of the mouth and dryness of the tongue. The dorsal decubitus position is impossible because it worsens the cough with expectoration of clear liquid. In summary, _ the disease of “Shui Qi” (Water energy) prevents the individual from stretching out because, in this position, cough is aggravated by the reflux of “Water” energy. _ boborygmi is caused by disturbance of the energy of the stomach. It can affect the spleen to stimulate sadness and anorexia.

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urine. These

_ the sensation of heaviness of the body with difficulty walking follows a disturbance of the circulation from the channel of the stomach to the lower limbs. _ in women, amenorrhea is due to an obstruction of the uterine vessels (Bao Mai). These vessels belong to the heart and connect to the uterus. When the “Water” energy (Shui Qi) refluxes toward the top, it compresses the lungs and prevents the energy of the heart from descending, hence amenorrhea.”

2. Zhang Jing Yue (1563-1640 A.D.) conveys the following elements:

“a) The lower eyelid also bears the name “place of dwelling of the silk worm” (Zua Xin). b) The imprint left after finger pressure is the sign indicating Feng Shui (edema of “Water-Wind” etiology). c) Smooth and slippery skin is the sign revealing disturbance of the organic liquid indicating the presence of Wind (Feng) coming from the exterior. d) Thinning of the region of Chi Fu due to the consecutive emptiness of Yin and Yang bears the name “Jia Ji” (atrophy) and originates from the disease of the incurable group of Cold-Heat (Han Re). e) Slippery skin as if it were greasy originates from the infiltration of Wind (Feng). f) Rough skin at Chi Fu signals insufficiency of blood. Non-diffused blood is the origin of “Feng Bi” (algoparesthesia of “Wind” etiology). 347. g) Verrucous (warty) skin, evoking the image of dries fish scales, originates from the weakness of EarthSpleen, from the withering/thinning of the “flesh” system and from the rising up of Water. Chapter 4 of this classic (“Pathologic Forms of Attack of the Organs and Bowels”) also mentions this. h) The skin of Chi Fu being burning hot, that of the body is surely very hot. It is a question of excess of perverse Yang. The disease then carries the name “Wen Bing” (disease of “moderate heat”). If the pulse has a “slippery” quality, this denotes the recuperation of the essential energy, indicator of the amelioration of the disease. i) Cold skin of Chi Fu with small pulse is the sign revealing deficiency of Yang energy, causal factor of diarrhea or the insufficiency of the energy (asthenia). The skin of Chi Fu first very hot (fever) then very cold (chills) is the sign of alternation of the disease of “Han Re” (Cold-Heat; intermittent fever).”

Figure 1: Forearm (Chi Fu)

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PARAGRAPH 2 the

“1- Heat localized only in the skin of the elbow indicates the attack of heat of supra-lumbar region.

2- Heat localized only at the skin of the back of the hand is the indicator of attack of heat of the infra-lumbar region. 3- Heat localized only at the skin of the external side of the elbow is the sign revealing attack of heat of the thoracic region. 348.

4- Heat localized only at the skin of the internal sdie of the elbow indicates attack of heat of the scapulo-dorsal region. 5- Heat localized only at the skin of the middle of the forearm is the indicator of attack of heat of the dorso-abdominal region. 6- Heat localized only 3 or 4 cun below the elbow is the sign revealing the presence of intestinal parasitosis. the

7- Heat localized only at the palm of the hand signals the presence of heat in abdomen.

the

8- Cold localized only at the palm of the hand indicates the presence of cold in abdomen.

9- The appearance of bluish-colored Luomai (venous vessels) at the level of thenar eminence is the indicator of the presence of cold in the stomach.” EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains: “This paragraph speaks about the different cutaneous zones of the external/internal, upper/lower elbow responding to the different parts external/internal, upper.lower parts. In effect, the two elbows being lower down, _ the upper part represents the upper part of the body _ the lower part, the lower zone of the body _ the external surface is Yang; it responds to the exterior part of the body _ the internal surface is Yin; it responds to the internal part of the lumbar and abdominal area (intestines, stomach...). Because the blood and energy circulate within the vessels responding to the energy of Earth (Di Qi) in order to reach Heaven, these circulate outside the channels responding to the energy of Heaven (Dan Qi) in order to diffuse to Earth. This is the path of conformity between Heaven and Earth.”

II - N.V.N.: This paragraph demonstrates the correspondences between the cutaneous regions beyond the elbow and

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certain large parts of the body. Therefore, observation of this part of the upper limb, considered to reflect the other regions of the body, allow a topographic as well as etio-pathogenic diagnosis of the ailment from a distance. 349.

We again find the following information in the commentaries of Zhang Jing Yue:

“The elbow is located behind the joint of the arm and forearm. The anterior part of the elbow is the site of passage of the three Yin channels of the hand. As a result, it responds to the anterior region of the thorax. The posterior part of the elbow is the forearm called “Shou” or “Bi”. It responds to the lumbo-abdominal region. The area located 3 cun below the elbow, that is to say, from the point Sanli (LI 10) to the wrist and that located 2 cun from the wrist, that is to say, from the point Neiguan (XB 6) to the elbow, belongs to the Yin part. When it is hot, it denotes the existence of parasites within the intestines. The palm of the hand is the site of reunion of the three Yin channels. As a result, it is the site of manifestation of signs of cold and heat coming from the exterior of the abdomen. The apearance of little bluish vessels at the level of the thenar eminence is the sign revealing the presence of cold within the abdomen. Chapter 10 of this classic (“Channels-Vessels”) also mentions this.”

Figure 2:

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Little venules on the thenar eminence. 350.

PARAGRAPH 3 pulse)

“Burning hot skin of Chi Fu and a changing (Da) pulse of Renying (carotid are the signs revealing an imminent hemorrhage.

Firm, hard skin of Chi Fu and a small and insufficient pulse of the Qi (energy) associated with a depressive syndrome (sadness. anxiety) are the signs heralding imminent death.

At the eyes, 1. The appearance of red color signals disease of Heart etiology. 2. The appearance of white color signals disease of Lung origin. 3. The appearance of green color signals disease of Liver origin. 4. The appearance of yellow color signals disease of Spleen origin. 5. The appearance of black color signals disease of Kidney origin. 6. The appearance of yellow mixed with other ill-defined colors signals disease localized in the middle of the thorax. • Examination of the eyes and diagnosis of ocular diseases: _ A red venule oriented from the top downward signals disease of Taiyang (SI and Bl) origin. _ A red venule oriented from the bottom upward signals disease of the Yangming (LI and St) origin. _ A red venule oriented from outside to intside signals disease of Shaoyang (SJ and GB) origin. • Examination of the eyes and prognosis of ocular diseases: _ A red venule oriented from the top downward toward the pupil signals death in one year. _ A red half venule, death in one and a half years. _ Two red venules, death in two years. _ Two and half red venules, death in two and half years. _ Three red venules, death in three years. • Diagnosis of odontalgias: Applying pressure on the Yangming (LI and St), _ if the channels is in excess, it is affected by Heat _ if it is at the left, the left is affected by Heat _ if it is at the right, the right is affected by Heat _ if it is at the top, the top is affected by Heat _ if it is at the bottom, the bottom is affected by Heat. • Diagnosis by blood vessels _ The abundance of blood of _ The abundance of blood of _ The abundance of blood of (algoparesthesia)

288

351.

(blood Luo: capillaries): red color indicates excess of Heat (fever) greenish color indicates excess of pain blackish color indicates chronic Bi disease

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_ The abundance of blood of red, black and green color indicates disease of Cold-Heat (Han Re, intermittent fever). Painful body, slight yellow color, yellow tartarous teeth, yellow nails... are signs of icterus (Huang Dan). The disease has the tendency to be dormant. Urine is yellow. The pulse is small and rough. The individual refuses to eat (anorexia). pulse)

In some individuals, a large or small, superficial or deep Cun Kou (radial resembling Renying (carotid pulse) indicates a disease difficult to treat.”

EXPLANATIONS AND COMMENTARIES I - Ma Shi explains: “1- The burning hot skin of Chi Fu and the changing (Da) pulse of Renying originate from the fullness of the 3 Yang, hence hemorrhage because the skin belongs to Yang and the blood vessels to Yin. The firm skin of Chi Fu and the excessively small occurs with the fullness of Yang and the exhaustion of Yin. This is why the prognosis is fatal.

2- The colors of the eyes represent the state of blood and energy of the 5 organs. The blood and energy of the 5 organs circulates in the interior of the vessels and manifests at Cun Kou (radial pulse) and their modifications appear at the eyes because the Jing (quintessence) of the 5 organs gather at the eyes. The previous paragraph speaks on the examination of the subocular region in order to determine cutaneous edema while this one addresses the examination of the colors of the eyes in order to appreciate the state of the Yin energy of the 5 organs. These two methods of examination are therefore based on observation of the exterior in order to evaluate the interior. The term “middle of the thorax” designates the diaphragm. Therefore, to speak of diseases located in the middle of the thorax is to speak of the energy of the 5 organs exteriorizing from the diaphragm. The problem becomes complex due to the appearance of colors in the course of the pathologic process. 352.

3- The first part of this paragraph concerns the examination of the colors of the eyes in the determination of the Yin energy of the 5 organs while this part gives dissertation on diagnosis based on ocular vessels to appreciate the energy of the 3 Yang. The colors respond to yang and the vessels to Yin. Here, it is a question of the transformation/modification between Yin and Yang. 4- Study is focused on the Xue Mai (blood and vessels) directed by the jueyin (XB) whose root is found at the Foot Shaoyin (Ki). Cold-Heat disease (Han Re) is due to the disturbance of Water energy and Fire energy, that is to say, of Yin and Yang. The energy of Xin Bao (XB) takes its source at the kidney and reaches underneath the heart. The pupil is formed by the osseous Jing of the kidney. The toxic energy of the Water Organ reaches the top and unites with the Fire Organ. During this time, the energy of the Fire Organ descends to the bottom and unites with Yin. This exchange is fatal. 5- The upper teeth belong to the Hand Yangming (LI), and the lower teeth, to the Foot Yangming (St). 6- “Painful body, yellow color, yellow tartarous teeth... the individual refuses to eat”: these are signs belongingt ot disease localizing at Earth-Center. The energy of Earth waters and saturates the 4 sides. “Painful body” indicates the manifestation of disease at the level of the flesh. “Slight yellow color” indicates the manifestation of disease at the level of the skin.

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“Yellow tartarous teeth” indicates the manifestation of disease at the level of the limbs. Icterus corresponds to the spleen. The small intestine also has the name “red intestine”, bowel belonging to the heart. The heart governs the Xue Mai (blood and vessels). “Urine of red yellow color with small and rough pulse” are signs of manifestation of disease at the level of the vessels.”

II - N.V.N.: This paragraph involves diagnosis by inspection of the eyes, teeth and blood capillaries. a - The Taiyang (Bl) has a vessels responding to the upper eyelid. This is why the red venules are oriented from the top downward and the disease is associated with the Taiyang (2). The Yangming (St) possesses a vessel responding to the lower eyelid. This is why the red venules are oriented from the bottom upward and the disease is associated with the Yangming. The Shaoyang (GB) circulates at the side of the external canthus of the eye. This is why the red venules are oriented from the exterior toward the interior and the disease is associated eith the Shaoyang. 353. 2. Compare with Chapter 13 (“Tendinomuscular Channels”).

b - Perverse energy infiltrates within the Yin part (of the body) and brings about the diseaswe of ColdHeat (Han Re) whose prognosis is founded on the appearance of red venules directed towrd the pupil. Chapter 70 of this classic (“Cold-Heat”) has mentioned it in relations to the prognosis of the scrofulas (Lua Li) (3). c - Icterus, according to Chinese medicine, is one of the pathognomonic signs of numerous diseases whose evolution enters into the sphere of the the Liver-Gallbladder and Spleen-Stomach systems. Based on the signs of Heat-Humidity or Cold-Humidity, one distinguishes two main types of icterus, “Yang Icterus” and “Yin Icterus”. Yang Icterus is due to a compression of perverse energy which becomes transformed into Heat-Humidity. It becomes concentrated and heats up the gallbladder hindering the circulation of bile which then does not follow the normal route and saturates the tissues to trigger Yang Icterus. Yin icterus is of dietary, physical or psychoaffective origin. The spleen and stomach become weakened. Central Yang (Zhong Yang) comes to a standstill with production of Heat-Humidity. It compresses the liver; bile extravasates and saturates the tissues to trigger Yin Icterus. In Yin Icetrus, the Spleen-Stomach system grows weaker; the pulse is small and rapid. This is why the individual becomes anorexic. d - Cun Kou (radial pulse) represents Yin, and Renying (carotid pulse), Yang, like spring and summer respond to Yin and Yang. to Biao (exterior) and Li (interior). If Cun Kou and Renying have the same quality, small or large, superficial or deep, the disease becomes surely oriented tpward Yin or Yang. They are the principal reasons for the difficulty of therapy. In this regard, recall the explanation of Leigong (Chapter 49: “The Five Colors”) above: Leigong: “How do you diagnose the worsening or improvement of the disease?” Huangdi: “Examination of the interior and exterior is essential. _ Mai Kou slippery (Hua), small (Wei), hurried (Jin) and deep (Chen) indicates worsening of the disease located in the interior, and Renying changing (Da), hurried (Jin) and superficial (Fu), the worsening of that located at the exterior. 354. _ Mai Kou superficial and slippery indicate progression of the disease, and Renying deep and slippery, its regression. _ Mai Kou slippery and deep indicates progressive worsening of the disease located in the interior, and

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Renying slippery, full and superficial, the progressive worsening of that at the exterior. _ Renying and Qi Kou both having the same qualities, superficial or deep, small or large, indicate a disease difficult to treat. In diseases of the organs, the deep and changing pulse indicates disease easy to treat. In contrast, the small pulse is unfavorable. In diseases of the bowels, the superficial and changing pulse also indicates disease easy to treat. Renying full and resistant indicates an ailment caused by Cold, and Qi Kou full and resistant, that caused by a digestive disorder.”

3. Compare page 244-246 above.

PARAGRAPH 4 “ In obstetrics, _ a pronounced

bounding/striking√

Shaoyin

pulse

indicates

pregnancy.

In pediatrics, _ bristling of head hair is fatal, _ the appearance of a retro-auricular venule indicates pain, _ diarrhea containing blood filaments accumulating in the form of grains of with small pulse but warm hands and feet is easy to treat.” EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains: “a- Shaoyin designates Yin Kidney. In women, the noting of a strongly agitated Chi (foot) pulse indicates that she is pregant and that the fetus is of masculine sex. The Suwen, in Chapter 18 (“Energetic Aspects of the Pulse of Man in Good Health”), also mentions this.

b- This paragraph speaks on the blod and energy of the human being whose source is innate (Pan Zian) (4). This blood and energy circulates in a spiral like a circle coming from the top downward and from the bottom upward. 355. From birth (of the human being), the body hair and head hair are surplus products of the blood originating from the Jing (quintessence) and Xue (blood). The head hair falls out because it responds to the quality of blood and energy carrying out rotatory movements from below upward and transforming into head hair; then the head hair returns toward the bottom. The bristling of head hair originates therefore from the rupture of phemonema of ascent and descent of the blood and energy. The prognosis is fatal. c- Diarrhea is distinguished also by liquid stools of yellow and red color.”

II - N.V.N.: Zhang Jing Yue gives us the following information: “1- Masculine sex of the fetus is diagnosed at the Chi (Foot) pulse of the left side. 2- “Bristling of the head hair” comes from the dryness of blood like a dried herb. Death is certain.

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3- “Lancinating pains” cited in this paragraph are of Liver-Gallbladder origin because: _ the Foot Shaoyang (GB) passes behind the ear _ green color is associated with the Foot Jueyin (Li) _ blue color responds to pain _ the liver responds to the muscles and tendons. Therefore, pains are due to disturbances of the Liver- Gallbladder system. Tian Zhen Fang has noted: “The appearance of Xue Luo (blood capillaries) of bluish color behind the ear above the point Wangu (GB 12) is one of the signs of epilepsy. It is necessary to make it bleed”. 4. Unfortunately, this is poorly transcribed by some French authors as “Anterior Heaven” (literal translation).

4- Diarrhea with blood-streaked stools indicates the presence of fire in the blood. If the pulse is small and if the hands and feet are cold, it is a matter of contrasting phenomena and the disease is diifcult to treat. In contrast, diarrhea without blood-streaked stools is not associated with the “fire” syndrome. The pulse is small, but the hands and feet are warm. In this case, the spleen governing the 4 limbs are still in a good state. This is why the disease is easy to treat.”

PARAGRAPH 5 “The changing climate of the 4 Seasons is dominated by Cold and Heat. Maximal Yin becomes transformed into Yang, and Maximal Yang, into Yin. Yet Yin governs Cold, and Yang, Heat. As a result, when the Cold reaches its maximum, it becomes transformed into Heat, and when Heat reaches its maximum, it becomes transformed into Cold. This is why, it is said: “Cold creates Heat and Heat creates Cold.” Such is the process of transformation of Yin and Yang.

356.

It is also said: ”_ In winter, perverse cold infiltrates nto the organism and remains in a latent state until spring to then trigger disease of heat. _ In spring, perverse wind infiltrates iinto the organism and remains in a latent state until summer to then trigger diarrhea and dysentery. _ In summer, perverse heat infiltrates into the organism and remains in a latent state until autumn to then trigger the disease of Heat-Cold (intermittent disease). _ In autumn, humidity infiltrates into the organism and remains in a latent state until winter to then trigger cough.”

“4

Such are the manifestations of disease conforming to the Seasons”.

EXPLANATIONS AND COMMENTARIES Zhang Shi explains: “This paragraph completes the previous one and speaks on the transformation of Yin and Yang, heat and cold.

1- “In winter, is one is affected by cold, in spring one will have the disease of heat (5), because toxic

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(perverse) cold remains in the epidermo-dermal layer and affects the organic Yang energy (organic heat which begins to become exteriorized in spring) becoming transformed into heat.

5. On must understand it to mean “Wen” disease (mild heat of spring).

“In summer, is one is affected by heat, in autumn one will have the disease of Heat-Cold (fever and chills; intermittent fever) because this toxic (perverse) heat remains in Mu Yuan (membranous layer) (6) and affects the organic Yang energy (organic cold which begins to become manifest in autumn) to trigger the disease Heat-Cold (of Yin type). In this manner, perverse cold and perverse heat follow the movements of “celestial transformation” to respectively bring about the disease of Wen Re (mild heat of spring) and the disease Heat-Cold. But the pathologic process also especially depends on the energetic state of the human being, that is to say, on the “terrain”. 357.

2- Yang Qi (Yang energy) belongs to Heaven. It governs the top. Yin Qi (Yin energy) belongs to Earth. It governs the bottom. Wind is the perverse Yang of Heaven. This is why, when one is affected by wind, the upper part of the body is always affected first. Humidity is the perverse Yang of Earth. This is why, when one is affected by humidity, the lower part of the body is always affected first. When Yang disease reaches the the uppermost part of the body, it returns to the bottom. This is why, if one is affected by wind in spring, in summer one will have diarrhea or dysentery. When Yin disease reaches the lowermost part of the body, it returns toward the top. This is why, if one is affected by humidity in autumn, in winter one will have cough. It is a question here of the Yin and Yang routes of Heaven and Earth. They also depend on the movements of ascent/descent-top/bottom of the 4 seasons.”

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6. Thin layer of tissue which envelopes an organ or lines a body cavity or natural duct or meatus: mucous membrane, serous membrane, fibrous membrane... aponeurosis, choroid, cornea, endocardium, sclera... false membrane... cell membrane, nuclear membrane... .

no 358/359.

CHAPTER

LXXV

Effects of Needling on the Source Energy and Perverse Energy (Ci Jie Zhen Xie)

Chapter 75 of the Lingshu speaks on: 1. The methods of “5 Delivrances Liberations/Releases” (Wu Jie): _ Chen Ai (shake off dust) _ Fa Meng (recover sight) _ Ju Chao (cut off nails) _ Che Yi (remove clothes) _ Ji Huo (free from troubles)embarras . 2. The methods of needling the “5 Perverse” (5 perverse energies: Wu Xie): _ Yung Xie (pyogenic energy) _ Dai Xie (great perverse energy) also called Shi Xie (full perverse) _ Wei Xie (small perverse energy) also called Xu Xie (empty perverse) _ Re Xie (perverse heat) _ Han Xie (perverse cold). 3. The evolutive process of Qi Xie (perverse energy) and the role of Zheng Qi (regular energy) and Chen Qi (source, original energy) in the etiopathologic process. 4. The causes of triggering of ailments such as: _ pain _ abscess

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_ _ _ _ _ _ _ _ _ _ _ _

hyperpyrexia chills pruritis blockage (obstruction: Bi) paresthesia osteoneuralgia muscular spasms hemiplegia “fullness of bones” (Gu Shi: osteoarthritis) tendinomuscular tumors bony tumors tumnors of the flesh (dermis).

360.

These ailments are due to attack of the Jingmai and to the defeat of the Zheng Qi (regular or essential energy). In other words, the perverse energy retained within the organism is the cause of disease whose seriousness is a function of the virulence of perverse energy and weakness of Chen Qi (source energy). In summary, Chapter 75 of the Lingshu speaks on the problem of the Chen Qi (source energy) and Xie Qi (perverse energy) and addresses the presentation of the “5 Delivrances” (Wu Jie) and the needling of the “5 Perverse (Wu Xie). This chapter contains 10 paragraphs.

PARAGRAPH 1 Huangdi: “Among the methods of needling, I have heard you speak of those of the “5 D e l i v e r a n c e s ” (Wu Jie). What are they?” Qi Bo:

“Actually, there exists methods called “5 Deliverances” _ The first is called Chen Ai (shake off dust). _ The second is called Fa Meng (recover sight). _ The third is called Ju Chao (cut off nails). _ The fourth is called Che Yi (remove clothes). _ The fifth is called Jie Huo (free from troubles).

Huangdi: “I would

like

(Wu

Jie).

preciseness.” 361.

Qi Bo:

“1- Chen Ai (shake off dust) is a method of superficial needling at the level of Wai Jing ( 1 ) to chase away perverse Yang. 2- Fa Meng (recover sight) concerns needling points of the Yang channels in diseases of the bowels.

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3- Ju Chao (cut off nails) is intended for needling Luo vessels belonging to the Guan Jie (doors of deliverance = doors of entry/exit of the energy: points of the principal channels).

1. External, peripheral channels.

4- Chi Yi (remove clothes) involves the needling of curious points located within Yang regions (of the body: epidermo-dermal layers). 5- Jie Huo (free from troubles) applies to needling according to precise knowledge of the principles of regulation, tonification and dispersion in order to normalize emptiness and fullness.” Huangdi: “Yau have spoken of the superficial needling of peripheral channels (Wai Jing) according to the method Chen Ai (shake off dust) used in the treatment of Yang diseases. I have still not perfectly grasped its meaning. Please tell me in detail.” Qi Bo:

“The method Chen Ai (shake off dust) is used in the treatment of great afflux/flooding of the Yang energy. Perverse Yang accumulating within the thorax causes such signs as: _ thoracic fullness and oppression _ supra-clavicular breathing (drawing and elevation of the shoulders) _ ascent of the Great Energy (Dai Qi) with: • dyspneic attacks • loud breathing, patient in seated position, head lowered • inability to lie down _ during the attack: fear of dust and smoke. Chen Ai is an urgent therapy like sweeping dust while cleaning a house.” Huangdi: “Very good! What point must one needle?” Qi Bo:

362.

“The point Tianrong (SI 17) . ”

Huangdi: “If there is cough with reascent of the energy, the patient is hunched up and the thorax is painful, what point should be needled?” Qi Bo:

“The point Lianquan (CV 23) . ”

Huangdi: “Are

there

special

rules

for

needling

these

points?”

Qi Bo:

“During the needling of Tianrong (SI 17) , the time the needle is placed must not exceed that covered in 1 Li (= about 1500 meters), and during the needling of Lianquan (CV 23), one must remove the needles upon the change of color (of the

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face of the patient).” Huangdi: “Excellent!”

EXPLANATIONS AND COMMENTARIES N.V.N.: 1- The exact title of this chapter is “Ci Jie Chen Xie”, literally “Needling of the Source Energy and Perverse Energy Points”. The word “Jie” (energetic articulation) designates the sites of the 365 reunions/meetings (points), sites of entry and exit of the Shen Qi (mental energy). “Ci Jie” implies that the infiltration of perverse energy impedes the circulation of the essential energy and that needling is directed at regulating and normalizing the Chen Qi (source energy). 2- “Wai Jing” (external channels) designate the peripheral trajectories of the 12 principal channels, and “Nei Jing” (internal channels), the central or internal trajectories traveling the intrathoraco-abdominal regions (at the level of the organs/bowels). Yang Shang Tian mentions: “The channels that enter into the organs/bowels are the Nei Jing and those that exit and travel the four limbs are the Wai Jing.” 363.

3- Regarding the method “Jie Huo” (free from troubles), Zhang Jing states: “To speak of Jie Huo is to speak of clinical problems; as a consequence, perfect knowledge of the method of harmonization of Yin and Yang and that of the regulation of Emptiness and Fullness can modifiy the state of the disease”. 4- Here, Dai Qi (Great Energy) designates Ting Qi (active, innate energy), that is to say, the energy of Qi Hai located in the thorax (bearing the name Shang Qihai = upper sea of energy). 5- According to Zhang Shi, fear of dust and smoke is the sign associated with disturbances of the Yangming (St) responding to Earth. Therefore, to “remove dust” and “chase away smoke” is to suppress the impure energy located at the Yangming. 6- The “sensation of obstruction of the laryngeal system” corresponds to dysphonia. 7- The point Tianrong (SI 17) belongs to the Hand Taiyang (SI). Its effect is to combat contrary afflux of the Yang energy, thereby aerating the corresponding channel. 8- During the afflux/flooding of the energy toward the top, “the individual is hunched over and the thorax is painful” due to the rupture of connection of the Celestial energy (air) and the Terrestrial energy (food energy). In this case, it is necessary to needle the point Lianquan (CV 23) to reestablish the normal circulation of the energy of the kidnay. 9- Tianrong (SI 17) and Lianquan (CV 23) are the two specific points used urgently in great attacks provoked by contrary afflux.

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Figure 1: Localization of Tianrong (SI 17) and Lianquan (CV 23). 364.

PARAGRAPH 2 Huangdi: “I have still not grasped very well the scope of the Fa Meng method (recover sight). To me, this method is useful for treating the loss of hearing and vision. But the Master has said that it concerns a method consisting of only needling the Shu points of the bowels in order to treat ailments of the 6 bowels. What then are the effective points to treat these diseases?” Qi Bo:

“A most pertinent question! This is a great method of acupuncture, a true art born of Shenming (clearsightedness, intelligence). Oral or written explanation cannot truly describe it. One names it “Fa Meng” (recover sight) due to its effectiveness as distinct as the act of brushing away dust to see clearly. Huangdi: “Good! Do you wish to give me the details?” Qi Bo:

“Needling used in the treatment of the loss of hearing (deafness) and loss of vision (blindness) must be performed at noon. Needling the point Tinggong (SI 19) must provoke in the patient a sensation along the length of the Jingmai up to the interior of the ear and the perception of sound in the ear. Tinggong (SI 19) of the Hand Taiyang (SI) is specific in the treatment of disturbances of vision and hearing.”

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Huangdi: “Your explanation is excellent! What indicates the perception of sound at the level of the ears?” Qi Bo:

“During needling, ask the patient to tightly close the two nostrils (using two fingers) and close the mouth. In this way, the individual better senses the reaction which is produced at the point of the needle (the individual hears sounds provoked by the needle).” Huangdi: “Very good! I call these phenomena the invisible effects of needling, perfectly concordant with the energetic transformations of the human body.”

EXPLANATIONS AND COMMENTARIES

365.

N.V.N.: 1- “Noon”, the middle of the day, is the maximal period of Yang energy. 2- The point Tinggong (SI 19) is the site of reunion-meeting of three vessels: Hand and Foot Shaoyang (SJ and GB) and Hand Taiyang (SI). 3- The Hand and Foot Shaoyang (SJ and GB) each have a vessel that penetrates into the ear from the rear and resurfaces in front of the ear to reach the external canthus of the eye. Needling Tinggong (SI 19) can therefore have direct effects on the ocular and auricular systems. When the needling is correct, the patient perceives a sound, like an echo, originating from the needle in manipulated movement by the physician. According to Zhang Jing Yue, this point Tinggong (SI 19) not only treats diseases “with form”, but also diseases “without form” (energy).

PARAGRAPH 3 299

Figure 2: Localization of the point Tinggong (SI 19).

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Huangdi: “Regarding the method Ju Chao (cut off nails), the Master has spoke of needling of Quan Jie (articulations) and of Chi Luo (energetic capillaries). I would like you to explains this to me in detail.” Qi Bo:

“The lumbar region and vertebral column constitute the principal articular system of the body. The trunk and limbs (lower) are the bolts and hinges of the pose of the standing position of the human being. 366. Yin Qi (penis) is an organ of reproduction, pairing and formation of Jing (sexual = sperm). It is also the route of liquid excretion (urine). This is why excessive eating or psychologic disturbances (joy, anger...) are the causes of overflowing of organic liquid in the interior, that is to say, within the tunica vaginalis of the testicle (or of the spermatic cord) which progressively enlarges (hydrocele). This liquid stasis at this level is injurous to the lower limbs and lumbar region, hence difficult flexing and straightening up the body and inability to walk or run. This disease is treated with the Pi type needle (needle with sword-like point used to evacuate liquid or pyogenic formations). Here, it concerns treatment of disease having form (hydrocele) that one cannot mask. This is why one lifts it up like one cuts nails short (Ju Chao) . ”

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains: “Diseases of the Taiyin (Sp) and Yangming (St) originate from a digestive disorder, and those of the Shaoyin (He and Ki) and Jueyin (XB and Li), from psychologic disturbances (excessive joy, anger...). When the organic liquid floods the interior, it accumulates at the kidney and stagnates at the testicles (hydrocele). For treatment, one must localize the disease at the level of one or another channel then needle the Chi Luo (energetic capillaries) situated at the level of the joints (knee). This technique bears the name “Ju Chao” (cut off nails, as if one lifts off an excresence).” II - N.V.N.: This paragraph speaks on the method of “Ju Chao” (cut off nails) and takes as a clinical example hydrocele whose treatment is compared to “clipping nails” because: _ the word “Chao” designates nails (of the digits) responding to the energy of the liver, _ the Foot Jueyin (Li) possesses vessels ending up at the genitals. Hydrocele has two causes: _ overflowing of organic liquid originating from a digestive disorder disturbing the Taiyin-Yangming (Sp-St) system and _ psychologic factors (excessive joy, anger...) disturbing the Shaoyin-Jueyin (Ki-Li) system.

PARAGRAPH 4

367.

Huangdi: “Regarding the method of Che Yi (remove clothes), you have spoken of needling the curious points of the Yang region, points not having a fixed location. Can you be more explicit?”

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Qi Bo:

“Here, it is a question of diseases originating from the excess of Yang energy and insufficiency of Yin energy. When the Yin energy is in insufficiency, it brings about internal heat, and when the Yang energy is in excess, it provokes external heat. During the accumulation of perverse heat in the interior (of the organism), the patient has the impression of having hot cinders within his body, and during the accumulation of heat at the exterior (at the level of the epidermo-dermal system), the patient has the impression of having a red hot body and cannot tolerate wearing clothes; he refuses the presence of anyone near him and even lying down on a mat. In _ _ _ _

this case, the Cou Li (sweat glands) are closed, hence the absence of sweating, the tongue is dry, the muscles are warm and dried out the sense of taste is abolished (agueusia).”

Huangdi: “Good! How should one treat this?” Qi Bo:

“Needle the points Tianfu (Lu 3) and Dazhu (Bl 11) 3 times to which one adds Zhonglu Shu (Bl 29) to make the perverse heat retreat. Then tonify the Foot Taiyin (Sp) and Hand Taiyin (Lu) to lower the fever by sweating. With the reduction of fever, sweating progressively disappears. Cure is always as quick as removing the clothes (Che Yi).” Huangdi: “Excellent!”

EXPLANATIONS AND COMMENTARIES N.V.N.: This paragraph speaks on the needling method whose effect is “as quick as undressing” (Che Yi), a method reserved for the treatment of excess perverse Yang and the insufficiency of Chen Qi (essential or vital energy of the body) whose clinical signs are basically: _ hyperthermia 368. _ absence of sweating _ curvature of the lumbar region (lumbalgia) _ loss of appetite... . Treatment consists of making the patient perspire thereby combatting fever. The points used are: • Tianfu (Lu 3) _ on the external border of the biceps brachii 3 cun below the anterior edge of the axillary fold, 6 cun above the elbow crease _ Window of Heaven point _ according to the Lingshu (Chapter 2: “Origin of the Shu (Antique) Points”), of Tianfu (Lu 3) and Tianchi (XB 1) one receives the energy, the other blood. Therefore, they moreover treat: hemoptysis, amnesia, myopia... .

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• Dazhu (Bl 11) _ 1.5 cun to the side of the spinal aponeurosis of the 1st dorsal vertebra in the first intercostal space _ Distinct Luo point of the Dumai (GV) _ reunion-meeting point of the Hand and Foot Taiyang (SI and Bl) and Hand and Foot Shaoyang (SJ and GB) _ reunion point of the energy of bones _ important point employed in neuro-psychiatry, especially in cases of epilepsy with spasm (Lingshu, Chapter 22, “Yin Madnesses and Yang Madnesses”) _ specific point making up part of the group of points used in the Che Yi method. • _ _ _ _

Zhonglu Shu (Bl 29) 1.5 cun to the side of the 3rd sacral vertebra point with tonifying action on the energy of the kidneys of the sacral region point with stimulating action on digestive functions point with curative action on coxo-femoral pain.

• Dadu (Sp 2) _ on the inner surface of the great toe in front of the metatarso-phalangeal joint _ point of tonification in the event of emptiness of the energy of the spleen _ sudorification point in fever _ specific point in the treatment of febrile illnesses without sweating.

Zhang Jing Yue gives us the following information: 369. “The point Dazhu (Bl 11) is specific in the treatment of illnesses of Cold-Heat (intermittent fevers). In the absence of fever during the disease of Shanghan (Evolutive Cold) with absence of sweating and thoracic oppression, one must needle Dazhu (Bl 11). The Hand Taiyin (Lu) governs the energy, and the Foot Taiyin (Sp), the cereal energy. When these two channels are found in a state of insufficiency, the Yang Qi (Heat energy) rises up toward the top and impedes the secretion of Yin Qi (Cold energy), hence febrile illness. This is why, to disperse the Yang, one must tonify these two Yang channels so that the Yin energy can circulate. When sweating appears, the fever regresses and the disease is cured.”

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Figure 3: Location of the points Tianfu (Lu 3), Dazhu (Bl 11), Dadu (Sp 2), Zhonglu Shu (Bl 29).

PARAGRAPH 5 Huangdi: “Regarding the method Jie Huo (free from trouble), you have emphasized the perfect knowledge of the method of regulariztion of Yin and Yang, the tonification of insufficiency and dispersion of excess in order to modify the emptiness and fullness and the mastering of the etiopathologic process. How do you get rid of these troubles?” Qi Bo:

“The direct attack of Wind (Chong Feng: apoplexy) brings the blood and vessels (energetic) toward emptiness and the perverse energy toward fullness. The limbs are paralyzed; movements of flexion/ straigthening up and rotatio of the body are abolished and the sense of orientation is lost. The disease is sudden; it localizes sometimes at the left, sometimes at the right and sometimes at the top, sometimes at the bottom of the body, in a deliberate/treacherous p e r f i d e fashion that is much more serious than simple disturbancese m b a r a s s . ” 370.

Huangdi: “Good! How is it treated?” Qi Bo:

“Disperse the excess (of perverse energy) and tonify the insufficiency (of the energy of the body) in order to reequilibrate Yin and Yang. The effect of the needling is as rapid as being delivered from trouble (Jie Huo).” Huangdi: “Perfect! Please carefully preserve this prescription in the library of Ling Lan. We must not divulge it in a botched upb a c l e e way.”

EXPLANATIONS AND COMMENTARIES N.V.N.: This paragraph speaks on Zhong Feng (direct attack of wind: apoplexy) causing an abrupt, more or less complete suspension of all functions of the 5 organs, in particular the function of reproduction of the Jing (quintessence), characterized by the sudden loss of consciousness and voluntary mobility with preservation of circulation and respiration. In Western medicine, “apoplexy” (1) or “apoplectic icterus” is due to a more or less total cessation of all brain functions (site of gathering of the Jing of the 5 organs). The two medicines, Western and Oriental, have

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therefore the same pathophysiologic reasoning. One must complete the other toward the same goal of preserving health. This example, adding numerous others, supports us in the conviction of allying and combining these two medicines in the interest of all. Zhong Feng or apoplexy has been studied since antiquity. It is a group of diseases characterized by sudden coma followed by: _ hemplegia _ deviation of the mouth and eyes _ tongue stiffness with dysarthria. However, in benign forms, one notes: _ absence of come, but presence of facial paralysis _ or hemiplegia without accompanying signs. According to the Suwen (Chapter 42, “Dissertation on Wind”): “Called “evolutive wind” (Shang Feng), a wind of cosmic (perverse) origin that attacks Shu points of the 5 organs and 6 bowels and progresses rapidly toward the interior of the body or a wind of organic (Nei Feng) origin that floods/affluxes toward the regions where the blood and energy are in a state of insufficiency. 371.

When this “empty-perverse energy” reaches the middle of the body, it invades deeply then destroys the Ying and Wei layers. Finally, the disappearance of the essential energy associated with the presence of perverse energy constitutes the two essential factors in the triggering of apoplectic syndromes: Yinshi (loss of voluntary movement, dysarthria, paresthesia or spasm and immobility of the limbs) and Wai Shi (deviation of the mouth and eyes).” According to Jin Kui (“Coffer of Gold”) of Zhang Zhong Jing (150-219 A.D.): “A direct attack of Feng against the superficial blood-energetic routes in the event of depletion can be at the origin of hemiplegia. From the Luomai system, the perverse energy first evolves toward the system of Jingmai, then into the system of organs/bowels. This progression depends on the superfificla or deep localization of the perverse energy and the benignness or seriousness of the disease.”

1. Sudden, usually marked, loss of bodily function due, in the West, to the rupture or occlusion of blood vessel (i.e. stroke).

These notions are recounted in numerous classic works. In the Tang (618-907 A.D.) and Song (960-1279 A.D.) Dynasties, Zhong Feng (direct attack of wind: apoplexy) has been identified as a disease having relationships not only to internal (organic) emptiness, but also with pathogenic (perverse energy) agents. It is from the Jin Kui (“Coffer of Gold”, 1115-1234 A.D.) that the pathophysiologic study of Zhong Feng was well developed. The disease can be caused: _ either by a fullness of Fire (according to Lui Hejian, 1120-1200 A.D.), _ by an emptiness of the energy (according to Li Dong Yuan, 1180-1251 A.D.) _ or by Humidity-Phlegm (according to Chu Dan Yi). Finally, according to other authors: a) Zhang Jing Yue (Ming Dynasty): “Perverse wind is not the cause of apoplexy”. b) Ye Tian Shi (Ching Dynasty): “Zhong Feng is basicaly due to “wind-fire” of Yang Liver. c) Zhang Ba Long, studying the Suwen, notes in regard to Chapter 62 (“Discourse on the Regulation of the

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Energetic Routes”): “The afflux/flooding of blood and energy toward the cephalic limit is the origin of a loss of consciousness followed by falling/collapsechute and an absence of voluntary movement without respiration or sanguinoenergetic circulation being interrupted. This loss of consciousness evolves toward the reestablishment of functions of awareness or toward fatal worsening.” The following development on Zhong Feng is based on these classic documents.

372.

I. The mechanism of triggering of Zhong Feng is extremely complex. It is basically due to: _ either an exhaustion of essential energy in the interior of the body, causing an emptiness at the superficial part at the level of the Luo vessels. This emptiness favors severe attack of pathogenic energy coming from the exterior (perverse energy), responsible for apoplexy, _ or an insufficiency of the “Liver-Kidney” system, causing a production of “InternalWind” (organic), essential factor in the triggering of Zhong Feng. In general, one distinguishes 5 different etiologies of Zhong Feng: 1. “External Wind” (perverse energy) 2. “Fullness of Fire” (organic) 3. “Internal Wind” (organic) 4. “Phlegm-Humidity” (organic) 5. “Emptiness of the Energy” (organic).

1- “External Wind” etiology According to the Suwen: “Zhong Feng has for an origin an emptiness of essential energy and a fixation of perverse energy within the organism”. Based on this notion, Zhang Zhong Jing adds in his book entitled “Jin Kui” (Box of Gold): “In Zhong Feng: _ the pulse is superficial and hurried: “hurried” corresponds to “Cold” and “superficial” to emptiness _ the Luomai are in emptiness and constitute vectors of perverse energy _ the perverse energy becomes localized in the hemibody√. These phenomena express as: _ a deviation of the mouth and eyes _ paralysis of half of the body (hemiplegia).” In total, depletion of the energy of the Luomai and the attack by perverse wind are the causes of apoplexy. Similarly, if the apoplexy is caused by an “internal emptiness”, it always necessary to take the external factor into account.

2. “Fullness of Fire” etiology After Lui Hejian, the tension of the Fire of the heart (therefore Xin Bao) is the origin of Zhong Feng. It is the consequence of an energetic disequilibrium originating from one of the following etiologies: _ psycoaffective disturbances _ digestive disorder _ psychologic fatigue _ sexual excess. 373. In this case, Water-Kidney is in insuffiency causing a slowing down of the Water movement. Water loses

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its inhibitory action on Fire. This provokes the phenomena called “Emptiness of Yin and Fullness of Yang” characterized by strong exhalation of Heat energy toward the cephalic limit, darkening of the mental sphere, causing loss of consciousness, then falling/ collapsechute. Zhang Ba Long of the Ching Dynasty is of the same opinion as that of Lui Hejian and gives the name “Da Jue” (great coma) to Zhong Feng. According to him, it is the great fullness of fire of the Heart-Liver system which transmits to the blood extremely accelerated movements toward the cranium, cause of a sudden attack.

3. “Internal Wind” etiology After Ye Tian Si, disturbances of the movement of Yang energy are the cause. In effect, the liver is the organ corresponding to Wind. When the Jing of the blood is in insufficiency, it brings about a dimunition of the Water-Yin movement which cannot sufficiently maintain Liver-Wood. he Yin part of the liver (Yin Liver) being empty, the Yang part of the Liver (Yang Liver) enters then into extreme fullness. This latter factor is responsible for the acceleration of the Yang movement, bearing then the name “Internal Wind”. In fact, the author bases this on the explanations of Lui Hejian to demonstrate the mechanism of triggering of internal wind in Zhong Feng.

4. “Phlegm-Humidity” etiology According to Chu Dan Yi, phlegm-humidity can be the origin of Zhong feng: “In the Northwest region (cold climate), Zhong Feng is due to an attack of perverse cold; the disease is then that of fullness. In the Southeast region (temperate climate with predominance of Earth-Humidity), Zhong Feng is due to an attack of this perverse humidity which within the organism becomes transformed into phlegm; this phlegm deteriorates into Heat and the Heat into Wind.” But for Zhang Jing Yue, this Heat-Phlegm of perverse origin is not truly the cause of apoplexy because, according to him: “Fire of the Heart-Fire system in a state of fullness heating up the organic liquid and transforming it into Phlegm-Humidity is responsible for Zhong Feng.” 5. “Emptiness of the Energy” etiology The terrain influences the appearance of Zhong Feng. In effect, according to Li Dong Yuan (alias Li Gao, 1180-1251 A.D.): “Zhong Feng is found: _ especially in angered individuals more than forty years old, the period during which the energy of man begins to grow weaker _ rarely in vigorous and balanced individuals _ sometimes in obese individuals.” 374. Based on the text of the Neijing, the Yang energy of the body bears the name “Wind” like the wind of Heaven and Earth. He adds: “Zhong Feng is not only a disease caused by an attack of perverse wind coming from the exterior, but also by a severe modification of the organic energy.”

II. As for symptomatologic study, the Jin Kui (“Coffer of Gold”) distinguishes Zhong Feng from benign, serious and topographic forms according to the localization of perverse energy at the level of the Jingluo and the organs and bowels:

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_ Attack of the Luo routes (secondary channels and superficial branches) become expressed by paresthesia. _ Attack of the Jing routes (principal channels) becomes expressed by a sensation of injury and heaviness. _ Attack of the system of bowels becomes expressed by a loss of consciousness. _ Attack of the system of organs becomes expressed by coma. To facilitate the symptomatologic study of Zhong Feng, we adopt the classification of the Jin Kui: _ symptomatology of the attack of the Jingluo _ symptomatology of the attatck of the organs/bowels. • Direct attack of the Jingluo They are the slight forms of apoplexy. The clinical signs are: _ either paresthesia, paresis or dysbasia (2) _ or absence of coma but presence of hemiplegia, stiffness of the tongue with dysarthria or facial paralysis _ or finallt coma (without seriousness) accompanied sometimes by fever, chills, spasms of the limbs _ tighttendu, slippery and superficial pulse. • Direct attack of the organs and bowels The premonitory signs of attack are: _ vertigo and cardiac palpitations _ or else dysarthria and paresthesia of the tips of the digits. At the time of the attack, the disease suddenly deteriorates into coma. In benign cases, resumption of awareness is nearly immediate. In contrast, in the serious cases, coma is always followed by: _ stertorous respiration _ deviation of the mouth and eyes 2. Difficulty walking.

_ hemiplegia _ stiffness of the tongue with dysarthria and dyscataposia (3).

375.

In the presence of these signs, one must immediately look to decelerate if it is a question of the “energetic obstruction” form or the form of escaping of the energy in order to apply an urgent treatment. a) Signs of obstruction The “Fire” energy being exhausted, the blood floods towrd the cephalic extremity; the “Wind” movement of the liver becomes accelerated with production of phlegm. The clincial signs are of “Yin” nature or “Yang” nature. • _ _ _ _ _ _ _

“Yang” Nature: closed hands trismus (4) stertorous respiration red facies anuria and constipation large, rapid and tighttendu pulse tongue with damp yellow coating.

• “Yin” Nature: _ absence of agitation

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_ snoring (phlegmyglarieux) _ deep and late pulse _ tongue with damp, smooth, white coating. b) Signs of Escaping The energetic root being exhausted, the Yang of the organism suddenly escapes. The clincial signs are: _ closed eyes _ open mouth _ opened hands _ stertorous or hypopneic (5) respiration _ urinary incontinence _ ice cold limbs _ galloping and weak pulse. In serious cases, the Yang root itself escapes. The clinical signs then are: _ flushing of facies (like covered with make-up) _ excessive sweating (in th form of little droplets) _ filant free-flowing, runny, very weak pulse (as if it is going to run out) _ or superficial, large and floating pulse.

3. Difficulty swallowing. 4. Lockjaw: tonic spasm of the muscles of mastication. 5. Breathing that is slower, shallower (or both) than normal.

Notes:

376.

1- In the face of coma, one must distinguish: _ “apoplectic coma” which denotes an abrupt, more or less complete cessation of cerebral function without suspension of respiration and sanguino-energetic circulation; it is clinicaly illustrated by facial paralysis and hemiplegia. After coma, paralytic sequelae are the rule. _ “epileptic coma” which is accompanied by generalized or localized convulsive fits. This coma can arise in apparent full health and there are no sequelae after the attack. _ “syncope” which is a severe and complete loss of consciousness linked to sudden cerebral anorexia. It is accompanied by extreme pallor and generally by respiratory arrest. It is provoked by a cardiac pause, bracycardia or excessive tachycardia or by sudden sanguino-energetic hypotension at the level of the Jingluo. 2- Therapeutically, meticulous search for specific signs is critical before applying an appropriate treatment. It is a question of a direct attack on the organs and bowels; treatment must be etiologic, based on the following signs: a. Fullness of Wind (Internal) _ headache _ visual disturbance _ vertigo _ paresthesia _ tense/tauttendu pulse, or _ spasms of the limbs. b. Surging of Fire (Internal) _ headache

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_ _ _ _ _ _ _ _ _ _

red eyes reddness of facies deviation of the mouth and eyes mouth dryness agitation amnesia constipation dysuria red tongue with a dry, yellow coat rapid, large pulse.

c. Emptiness of Energy _ psyhesthenia _ cardiac palpitations _ hyperpnea _ fear of speaking _ polyuria, clear urine _ tense and galloping pulse

377.

d. Phlegm-Humidity _ pale color _ slimy expectoration _ limb paresthesia _ damp tongue _ slippery pulse. This detailed study of the pathophysiology of apoplexy allows us to understand the necessity of uniting Western and Oriental medicine because, according to the Neijing, diseases originate from the modification of the energy of the body. This is why, in order to treat apoplexy, one must know how to harmonize Yin and Yang, tonify insufficiency and disperse excess. This method permits “freeing from troubles” (Jie Hua).

PARAGRAPH 6 Huangdi: “I have heard you speak of the needling method “Wu Xie” (“5 Perverse”) . What do you mean by “5 Perverse”?” Qi Bo:

“Diseases are caused by “Yung Xie” (pyogenic perverse energy). Diseases are caused by “Dai Xie” (perverse energy of great virulence). Diseases are caused by Wei Xie (perverse energy of weak virulence). Diseases are caused by “Re Xie” (perverse heat). Diseases are caused by “Han Xie” (perverse cold). Such are the diseases caused by the 5 Perverse.”

Huangdi: “ What are the needling methods of the 5 Perverse?”

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Qi Bo:

“The method of needling of the 5 Perverse do not exceed the number 5: 378.

1- Method of extermination of the heat in the case of Bi Re (obstruction caused by heat = inflammation, abscess). 2- Method of extermination of energetic stasis in the case of edema and accumulation. 3- Method of potentiation of heat to warm up the blood and energy in the case of Bi Han (obstruction caused by cold). 4- Method of tonification of the Yang energy in the case of Wei Xie (perverse energy of weak virulence). 5- Method of dispersion of the perverse energy in the case of Dai Xie (perverse energy of great virulence). That His majesty allow his subject to demonstrate to him in detail the use of these 5 methods! In effect, 1- Needling Yung Xie (pyogenic perverse energy) consists of not expeditiously dispersing the perverse energy in full evolutive phase. The procedire must be carried out slowly and lightly as if one was in the process of realizing/starting to realize a modification of usage and nature√ √ . If the abscess is not yet formed, one must soften by massaging it or else use the method of conduction of the energy which consists of making the perverse energy circulate to aid it in leaving its site of stagnation. To do so is to progressively eliminate the pyogenic energy. If Yung Xie is located at the level of the Yin channels or Yang channels, one must follow it or the corresponding channels to choose the channel and the points to disperse√ . 2- The needling of Dai Xie (great perverse energy: perverse energy of great virulence) consists of decreasing its toxicity in progressively weakening it. This is a method of dispersion aimed at strongly and rightly striking the circulatory route of the perverse energy as a function of the change in color and pulse. One must also carefully observe the state of the perverse energy and essential energy in order not to disturb the source energy (Chen Qi). Needling must be performed at the level of the Yang channels located at Fen Rou (region of distribution of the flesh) because, in the majority of cases, Dai Xie is found in this region. 3- The needling of Wei Xie (small perverse energy: perverse energy of weak virulence) consists of increasing the potential of the essential energy of the body in a state of emptiness by tonification in order to prevent the perverse energy from being detrimental to it. Before tonification, it is recommended to carefully observe the Emptiness and Fullness and aim at just the right site of the cirulation of the perverse energy. To act in this manner is to normalize the 3 7 9 . circulatory route of the essential energy so that the perverse energy no longer has a place to infiltrate into the organism. Needling must be performed at the level of Fen Rou (region of distribution of the flesh).

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4- The needling of Re Xie (perverse heat) consists of transforming the heat into cold and of preventing its return to avoid its relapse. During the implantation of the needle, one must enlarge the point of impact to facilitate the exteriorization of the perverse energy to assure cure. 5- The needling of Han Xie (perverse cold) consists of progressively rectifying the heat in the blood and energy. The implantation of the needle must be done slowly to consolidate the return of the Shen Qi (mental energy). After removal of the needle, one must close off the point of impact (with the aid of the finger) to retaqin the energy (to prevent its exit) in order to augment the potential of the Ying (nutritive energy) and Wei (defensive energy) thereby preserving the source energy (Chen Qi).” Huangdi: “What types of needles should be used in the treatment of the 5 Perverse (Wu Xie)?” Qi Bo:

“In order to needle Yung Xie (pyogenic perverse energy), one uses the P i type needle (with sword-like tip, 4 cun long, 1.6 wide). To needle Dai Xie (perverse energy of great virulence), one uses the Feng type needle (with triangular tip, 1.6 cun long). To needle Wei Xie (perverse energy of weak virulence), one uses the Y u a n type needle (with oval point, 1.6 cun long). To needle Re Xie (perverse heat), one uses the C j h a i type needle (with big s h a f t / h a n d l e m a n c h e and head like an arrow tip). To needle Han Xie (perverse heat), one uses the Hao type needle (with filiform point, 3.6 cun long).

EXPLANATIONS AND COMMENTARIES N.V.N.: Zhang Jing Yue clarifies this information: “1- Needling Yung Xie (abscess): 380. When the abscess has not yet formed, one must resorb it: _ either by massage _ or by medications for external use (lotion, pommade, creme, plaster, patch...) _ either by acupuncture _ or moxabustion. 2- Needling Dai Xie (great perverse energy or perverse energy of great virulence): Dai Xie bears the name Qi Xie (curious perverse energy) whose needling must not be performed without reflexion. Before needling, one must determine: _ the state of the perverse energy and essential energy _ and the state of the pulse and colors. 3- Needling Wei Xie (perverse energy of weak virulence): Wei Xie also has the name Xu Xie (empty perverse energy) whose treatment is understood to have two phases: _ first tonification of the channel or channels in a state of emptiness

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_ disperse the channel or channels in a state of fullness. This technique allows potentiation of the essential energy and weakening of the perverse energy. 4- Needling of Re Xie (perverse heat): The technique consists of transmitting to the needle rapid movements and widening the point of impact to facilitate the evacuation of perverse energy. In other the disease, one must deobstruct the points of impact, that is to say, “open the doors” to chase out the perverse energy. 5- Needling Han Xie (perverse heat): The technique consists of transmitting to the needle slow movements to guarantee the return of the Chen Qi (source energy- term emcompassing the functions of Ying and blood and energy) in the heat.”

words, to cure

Wei,

The 5 types of needles cited in this paragraph are mentioned in Chapter 1 (“9 Needles and 12 Yuan”) of this classic.

PARAGRAPH 7

“That His majesty permit his subject to speak to him about the significance of the Jie Jie method (untie the knot). It concerns one of the methods of reasoning encompassing: _ the correspondences between Heaven and Earth _ the relationships between the seasons _ and the participation of the human being in these manifestations of the natural world. 381. In effect, based on these phenomena, one can know the direction of outcomesens de denouement perfectly. In this way, for example: In a humid place, in the substratum is surely found a subterranean source of water and the sun pushes up the reeds and les acores√ . In relying on these facts, one can judge the importance of the shortage or abundance of the energy in man. • Yin and Yang become transformed into heat and cold. a) When it is cold, the heat warms up the water on the surface of the earth and transforms it into clouds and rain. This is why the roots (of trees) often suffer from dryness. In man, when it is hot, Yang energy escapes to the exterior and causes laxity of the pilocuteaneous system, hence: _ opening of the pores _ decreased potential of blood and energy _ and damp skin. b) When it is cold, water becomes transformed into ice. In man, Yang energy is retained in the interior (deep), hence: _ closure of the piolcutaneous system _ absence of sweating _ toughening of the blood/energy system _ rigidity and redness r u g o s i t e of the flesh system.

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• _ _ _ (caused

This is also the time when: man liking to sail can no longer circulate about the ice man liking to dig in the earth can no longer dig a hole in the ice man skillfully using needles can no longer treat ice cold limbs by Jue Ni: contrary afflux of cold).

• Blood vessels become rigid from the cold and cause disturbances of mobility. One cannot soften them instantly. It is like sailors forced to wait for beautiful weather (when the ice melts) before being able to sail or for the man of the soil before being able to dig a hole in the earth. It is the same for blood vessels and energetic vessels. Treatment of Jue Ni (cold hands and feet) consists basically of utilizing Hua Qi (fire energy: moxabustion) to heat up the Jingmai located at the level of the great joints. 382.

When the heat (organic) is retained, the energetic and blood vessels circulate freely, and this is the time to examine the clinical signs: _ if the pulse beats without difficulty, acupuncture is used to reestablish the harmony of the blood and energy _ if the pulse is hard and hurried (signs of fullness of the perverse energy), the technique of dispersion must be employed to wipe out the stases, toughenings and blood and energetic accumulations. The procedure must be repeated until the potential diminution of the energy of Jue Ni (contrary afflux). This is what one calls the method of Jie Jie ( o u t c o m e ) .

EXPLANATIONS AND COMMENTARIES N.V.N.: This paragraph speaks on the meaning of Jie Jie (outcome, conclusion). 1- As man responds to Heaven and Earth, he must know the Dao (principles, rules) of the natural world. This knowledge is the same resolution of the word “outcome” (denouement)√. 2- Subterranean water, reeds and acores are the manifestations located, respectively, in the interior (Li) and at the exterior (Biao) of the earth. In man, Biao and Li designate the anatomic layers at the level of which one determines the emptiness and fullness of the blood and energy. 3- To treat cold hands and feet (caused by Jue Ni: contrary afflux), it is necessary to use: _ first, moxabustion _ second, acupuncture. This therapy is one of the methods of Jie Jie (outcome, denouement). As a result, the term “Jie Jie” also implies the sense of freeing accumulations of perverse energy.

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“The essential effect of needling is to harmonize the circulation of Qi ( e n e r g y ) . Q i , originating from food metabolism and preserved in the stoamch, is the source (of the formation) of Ying (Rong: nutritive energy) and Wei (defensive e n e r g y ) . Y i n g and W e i circulate following their own route except the Tong Qi (active, innate energy) . Tong Qi accumulating within Shang Qihai (upper sea of the e n e r g y ) reaches the respiratory routes and the Tong Qi accumulating within the Xia Qihai (lower sea of the energy) descends to Qichong (St 30) toward the feet. 383.

This is why, when Cold-Yin causes Jue Ni (contrary afflux responsible for cold feet), Tong Qi can no longer descend and provokes the stagnation of blood and energy. If moxabustion is not used to activate the energetic and blood circulation, one cannot treat it by acupuncture. During treatment by acupuncture, the physcian must judge the emptiness and fullness of the Jingmai (principal channels) while palpating them, percussing the points of impact and observing the corresponding reactions. One then can treat the energy which spontaneously descends. The harmony of the 6 channels (3 Yin and 3 Yang of the foot and hand) indicates the absence of disease or, if they all present the same, it cures spontaneously√ √ . a) If one of the 6 channels presents phenomena of fullness at the top and emptiness down below , it involves the excess of the energy of Heng Luo (transversal Luo vessel) which impedes the circulation of the principal channel. The treatment consists of determining the Heng Luo effected and dispersing it. This technique also carries the name Jie Jie (undo the knot). b) In the case of cold at the top and heat down below , it is advised to needle the cervico-nuchal region belonging to the Foot Taiyang (Bl) and leave the needle in place a long time. After needling, it is necessary to apply moxabustion to the scapulo-cervico-nuchal region to assure the normal descent of the heat. c) In the case of heat at vessels in a state of emptiness Stop the procedure when the This technique is known bottom”.

the top and cold down below , one must examine the blacked at the bottom of the body and tonify them. Yang energy begins to descend. as “to conduct the heat from the top toward the

d) In the case of strong fever (hyperthermia) accompanied by Yang Madness (Kuang), visual and auditory hallucinations, raving... it is recommended to needle the Foot Yangming (St) and its Dai Luo (great Luo of the stomach) in tonification in the event of emptiness of the energy and in dispersion in the event of fullness of the blood. Moreover, the physician must ask the patient to lie down on his back and, grasping the front of his head with two hands, he presses and massages himself along the 2 Renying (St 9) and the 2 Daiying (St 5) with 4 fingers (thumbs and index fingers) according to the manual methods called “Juan” (roll) and “An” (press), pushing from the top downward to the middle of Quepen (St 12). The procedure is stopped upon the disappearance of the heat. This technique bears the name “to push and disperse”. ”

EXPLANATIONS AND COMMENTARIES

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384.

N.V.N.: 1- This paragarph speaks about the harmonization of Qi (energy). But the word “Qi” designates at the same time: _ Ying Qi (Rong: nutritive energy) circulating within the channels and _ Wei Qi (defensive energy) circulating outside the channels _ and Tong Qi (innae, active energy) localizing within the thorax and abdomen. According to Zhang Jing Yue: “Tong Qi, also called Dai Qi (great energy), is located at the level of Qihai (sea of energy) of the superior (thoracic, CV 17) region and inferior (abdomianl, pelvic, CV 6) region. Superior Qihai (Shang Qihai, CV 17) communicates with the respiratory routes. Middle Qihai (Zhong Qihai, CV 12) communicates with the digestive routes. Inferior Qihai (Xia Qihai, Cv 6- “Sea of Energy”) passes to the point Qichong (St 30) to reach the feet.” (Figure 4).

Figure 4: Shang Qihai (Tanzhong, CV 17), Zhong Qihai (Zhongwan, CV 12), Xia Qihai (Qihai, CV 6) and Qichong (St 30).

The word “Qi” (energy) designates therefore Ying, Wei and Tong Qi. Clinically, one must determine these types of energy toward a therapeutic goal. 385.

2- The word “Jue” (“afflux”, flooding) implies the sense of Jue Ni (contrary afflux), that is to say, afflux (flooding) of the Cold-Yin energy. When this phemonemon of flooding occurs at the foot, the circulatory path of

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the Yang energy is blocked and the Tong Qi can no longer descend. As a result, one must use moxabustion to combat the cold because acupuncture alone cannot resolve the problem of Jue Ni (contrary afflux or flooding). 3- The 6 channels designates the 3 Yin and 3 Yang of the foot and hand. The harmony of these Jingmai is synonymous with the absence of disease. • Case of fullness at the top and emptiness below originates from the afflux of the energy of the channel of the foot. One must examine the Heng Luo (transversal Luo vessel) of the corresponding principal channel and disperse it. This technique also has the name “Jie Jie” (untie the knot). • Case of cold at the top and heat below According to Zhang Shi: “This syndrome is due to the ascent of the Xiajiao (Lower Jiao) which goes from the bottom upward. The Taioyang, master of the energy of the Yang channels, originates from Water of the bladder and the disease of cold at the top and heat at the bottom is due to a blockage of the energy of Taiyang at the bottom. This is why it is recommended to needle the points of the cervico-nuchal region belonging to the Taiyang to bring the energy toward the top. During the needling, one must moreover apply moxabustion to the region which extends from the neck to the nucha toward the shoulder until the energy (heat) of the bottom reaches the top.” And Zhang Jing Yue adds: “The ailment characterized by cold at the top and heat at the bottom is due to the emptiness of Yang above and fullness below. First, one must needle the points Dazhui (GV 14) and Tianzhu (Bl 10) of the cervico-nuchal region to which is added moxabustion until the ascent of the energy (heat).” This technique is named “Push the energy fron=m the bottom toward the top”.

Figure 5: Localization of the points Tianzhu (Bl 10) and Dazhuoi (GV 14).

• Case of heat above and cold below According to Ma Shi: “In the ailments caused by heat at the top and cold down below, one must examine the collapsedaffaisee vessels of the region of the Jingmai to tonify them in order to bring the energy from the top toward the bottom. This technique has the name “to conduct the energy from the top toward the bottom”. 386.

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• Case of strong fever with hallucinations, mental confusion... . Strong fever injures the blood and energy. One must tonify the Foot Yangming (St) and its Dai Luo (Great Luo) because the stomach channel contains much blood and energy. Together with acupuncture, massage must be used according to the Juan (roll) and An (push) methods at thelevel of the points Daiying (St 5), Renying (St 9) and Quepen (St 12) until the disappearance of the heat. This technique is called “to push and disperse”.

Figure 6: Localization of the points: Daiying, Renying and Quepen.

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PARAGRAPH 9 Huangdi: “One channel can create numerous diseases _ in the form of pain _ in the form of abscess _ in the form of Heat (fever) _ in the form of cold (chills) _ in the form of itching sensations _ in the form of numbness (Bi) _ in the form of paresthesia... . Their evolution is limitless. What is their cause?” Qi Bo:

“They are all caused by Xie Qi (perverse energy) of a different nature.” 387.

Huangdi: “I have heard you speak of numerous Qi (energy): _ Zheng Qi (principal, standard energy) _ Chen Qi (original, source energy) _ and Xie Qi (perverse energy). What do you mean by “Chen Qi” (source energy)?” Qi Bo:

“1- The source energy (original, Chen Qi) originates from Tian Qi (energy of Heaven: respiration) and from Di Qi (energ of Earth: foods) to maintain the body. 2- The principal, regular energy (Zheng Qi) is also called Zheng Feng (regular wind) coming from one of the 4 cardinal directions responding to the corresponding season. This regular wind (Zhong Feng) reveals neither the nature of Shi Feng (Emptiness/Fullness: destructive wind) nor that of Xu Feng (Emptiness/Wind: wind that only penetrates into the organism when one is in emptiness). 3- Perverse energy (Xie Qi) has nin it the nature of Xu feng (Emptiness/Wind), injurous to the energy of man. With each intrusion, it deeply infiltrates into the organism and can no longer be released. In contrast, Zheng Feng (regular wind) only affects man superficially. it can use the Chen Qi (source energy) to be brought to the exterior. In other words, at each occurence, Zheng Feng is not very powerful and cannot triumph over the Chen Qi (source energy). This is why, generally, it evacuates itself.”

EXPLANATIONS AND COMMENTARIES N.V.N.: Zhang Jing Yue furnishes us with the following information:

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“1- Chen Qi (source energy) also has the name Yuan Qi (original energy), This energy has two components: _ the energy of Heaven (Dan Qi) which penetrates into the organism via the respiratory route _ and the energy of Earth (Di Qi) which penetrates into the organism via the digestive route. Before birth, man receives the a priori energy, and after birth, the a posteriori energy (6). 2- The energy circulating within the Yang region (of the body) bears the name Yang Qi, and that circulating within the Yin region, Yin Qi. 388. The energy circulating in the interior (of the channels) is Ying Qi (nutritive energy), and that circulating at the exterior, Wei Qi (defensive energy). The energy localizing at the spleen is Xung Qi (excitingexaltante energy of the distribution). The energy localizing at the stomach is Wei Qi (gastric energy). The energy localizing at Zhongjiao (Middle Jiao) is Zhong Qi (center energy). the energy localizing at the Xiajiao (Lower Jiao) is Yin-Yuan (Yin source) and Yang Yuan (Yang source). 3- Zheng Feng (regular wind) is the seasonal wind which regularly occurs slowly and harmoniously. this is the productive wind opposed to Shi Feng (Fullness/Wind) of destructive nature very harmful to man.”

PARAGRAPH 10 “1- When Xu Xie (perverse emptiness) attacks man, it causes such signs as: _ chills _ piloerection _ opening of the pores. 2- When _ at the blockage) _ at the _ at the 3energy. abcdesystem.

it infiltrates deeply into the organism: level of the bones, it causes Osseous Bi (bony

obstruction:

level of the muscles, Jin Luan (muscular spasm) level of the vessels, Blood Bi (blood obstruction) and forms abscesses.

When it attacks the flesh system (dermis), it opposes the Wei (defensive) In this case, if the perverse Yang is victorious, it causes syndromes of heat . if the perverse Yin is victorious, it causes syndromes of cold. if the cold is victorious, the Chen Qi (source energy) goes away. if the Chen Qi goes away, the Yang is in emptiness. if the Yang is in emptiness, the perverse cold attacks the pilocutaneous

6. One can become perplexed when some acupuncturists refuse to accept the word “energy” to designate “Qi” and translates it as “breath” or when some authors deny the words “a priori”, “a posteriori” (Tian tian, Hui tian) and translate these as “anterior Heaven” and “posterior Heaven”.

f- if the perverse energy comes back out via the cutaneous route, it causes opening of the pores and agitation of the hairs (piloerection). g- if the perverse energy follows the path of the Ying (nutritive) energy and the Wei (defesnive ) energy to enter and exit, it causes “itching”. 389. h- if the perverse energy stagnates, it causes Bi (obstruction).

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i- if the Wei energy stagnates, it causes “loss

of

sensation”

(paresthesia).

4- When the Xu Xie (perverse emptiness) only infiltrates into half the body and deeply reaches the organism, it dwells with the Ying (nutritive energy) and Wei (defensive energy) weakening them. The Chen Qi (source energy) then abandons its place and, finally, the perverse energy alone persists and causes Tian Ku (hemiplegia) . If the infiltration of perverse energy is relatively less deep, it causes the dysharmony between the blood and energy, responsible for pain of the hemibody. 5- When the Xu Xie (perverse emptiness) penetrates deeply into the organism and remains there for a long time, it causes the confrontation of cold and heat. _ If the cold is victorious, it causes bony pain (osteo-neuralgia) with alteration of the flesh system ( a t r o p h y ) . _ If the heat is victorious, it causes bony necrosis (osteonecrosis) with pyogenic formation. _ If the heat infiltrates into the bone, it causes Gu Shi (osteomalacia), 6- There are diseases caused by perverse energy at the level of the tendinomuscular system triggering disturbances of flexion and extension. In the chronic state, the Wei (defensive) energy is the cause of Jin Lui (tumors of the muscles). 7- There are diseases caused by chronic stasis of perverse energy. In this case, the Wei energy pursues the aggressive movement of the perverse energy and can no longer return to the exterior. It is the same for the Xin Ye (organic liquid s u b s t a n c e s ) which stagnate within the stomach and intestines. In the chronic state, the collection of these stases (perverse energy, Wei energy and organic liquids) form Zhang Lui (intestinal tumors) . 8- There are diseases caused by chronic stasis of perverse energy over several years, supple to palpation, slowly progressing more deeply and leaving behind it an accumulation of Xin Ye (organic liquid substances). With each new attack of perverse energy, the disease worsens: _ disturbance of the circulation of blood and energy _ increase in the volume of static mass _ and transformation into Xi Lui (tumor of static origin). 9- There are stases hard to palpation caused by a chronic accumulation of perverse energy at the level of the osseous system. In the chronic state, they penetrate deeply into the bone and adhere to the bony fibers which rapidly increase in volume to trigger Gu Lui (osseous tumors) . 390.

10- There are diseases caused by the accumulation of perverse energy at the level of the flesh (dermis) to which are added those of the Tong Qi (active, innate energy). The perverse energy favors heat and suppuration. The area uneffected by the heat transforms into Rou Ju (tumors of the flesh) . All these perverse energies manifest in non-fixed locations, but they all have precise names.”

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EXPLANATIONS AND COMMENTARIES N.V.N.: This paragraph speaks on the formation of numerous diseases of energetic origin: _ _ _ _ _ _ _ _ _ _ _ _

joint blockage abscess pruritis hemiplegia (accompanied by pain of the hemibody or not) ostealgia osteonecrosis osteomalacia muscular tumors intestinal tumors tumors of static origin osseous tumors dermal tumors... .

391.

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Book IX

Boox IX consists of 6 chapters:

Chapter 76: Movements of the Wei Energy (Wei Qi Xing) Chapter 77: 9 Palaces - 8 Winds (Jiu Gong Ba Feng) Chapter 79: Dissertation on the “9 Needles” (Jiu Zhen Lun) Chapter 80: Years and Dew (Zuo Lo) Chapter 81: Abscesses and Tumors (Yung Ju)

no 392/393.

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CHAPTER LXXVI Movements of the Wei Energy (Wei Qi Xing)

Chapter 76 of the Lingshu speaks on the circulation of Wei energy. it carries out 50 cycles around the body during one day and one night, that is, 25 passages within Yang and 25 within Yin. It is stated by our ancient masters: “Wei energy is the “sea of 100 diseases”. Its circulation obeys very precise rules and is divided into “Yin-Yang/Day-Night”. Needling as a function of a schedule/timetablehoraires can potentiate the effect of treatment.” This chapter also addresses the problem of the wait for the arrival of the energy at the level of the 3 Yin and 3 Yang during application of the method of tonification and dispersion. This chapter consists of 5 paragraphs.

PARAGRAPH 1 Huangdi: “ I would like to hear you speak about the circulation of the Wei (defensive) energy and of its movements of entering and exiting from the “Yin/YangInterior/Exterior” of the body.” Qi Bo:

“The year has 12 months, and the day, 12 hours. ( 1 )

Zi (1st Terrestrial Branch) and Wu (7th Terrestrial Branch), located respectvely to the South and North, form the Jing (vertical line: celestial longitude). 394. Mao (4th Terrestrial Branch) and You (10th Terrestrial Branch) , located

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respectively to the East and West, form the Wei (horizontal line: celestial latitude). The solar convolution around the 28 constellations desrcibe in obvious fashion the 4 cardinal points (East, South, West, North) which gives 28/4 = 7 constellations for each cardinal point. The line traced from East to West, from the F a n g star to the M a o star, becomes the Wei (celestial latitude) and that traced from North to South, from the X u star to the Z h a n g star, becomes the Jing (celestial longitude). From there, _ from the F a n g star of the East, the Jing (celestial longitude), which passes via the South. arrives at the P i star of the West and crosses near to the 14 constellations, is Yang. _ and from the M a o star of the West, the Jing (celestial longitude), which passes via the North, arrives at the X u star of the East and crosses near to the 14 constellations, is Yin. Yang governs day, and Yin, night. This is why the circulation of the Wei energy and the solar convolution are similar and is subject to the same law. In 1 night and 1 day the Wei energy travels around the body 50 times. During the day, it circulates 25 times in the Yang, and at night, 25 times in the Yin where it carries out rotative movements in the same time at the level of the inter-organ spaces.”

EXPLANATIONS AND COMMENTARIES I - Ma Shi explains: “This paragraph speaks on the circulation of the Wei energy during the day and night. a) The Zi hour (23-1h) corresponds to the middle of the night (midnight), and the Wu hour (11-13h), the middle of the day (noon). These periods respond to Jing (longitude: North-South). The Maohour (5-7h) corresponds to the morning, and the You hour (17-19h), to the evening. These periods respond to Wei (latitude: East-West).

b) The celestial vault consists of 28 constellations. The Fang and Mao stars are located at Wei (latitude: East-West), and the Wu and Zhang stars, at Jing (Longitude: North-South). 395. 1. One Chinese “hour” = 2 Western hours.

As a result, the stars located between Fang and Pi are Yang, and those located between Mao and Xin are Yin. Jing Yang govern day, and Jing Yin, night. In man, during one day and one night, the Wei energy circulates 50 times around the body. During the day, it circulates 25 times at the level of the Foot and Hand Yangming (St and LI). During the night, it circulates 25 times atthe level of the Yin channels, beginning at the Foot Shaoyin (Ki) and ending at the Foot Taiyin (Sp)... .”

II - N.V.N.: a) Zhang Jing Yue gives us the following details: “ _ The 12 hours designate the 12 Terrestrial Branches. (2) _ Jing (celestial longitude) is static. _ Wei (celestial latitude) is dynamic. _ Zi (1st Terrestrial Branch) and Wu (7th Terrestrial Branch) are located respectively at the North pole and South pole. They do not move). This is why the line connecting these 2 poles is named Jing (celestial longitude). _ Mao (4th Terrestrial Branch) is oriented toward the East and is subjected to the movements of ascent.

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This is why the line connecting these 2 cardinal points is named Wei (celestial latitude). _ Heaven is divided into 4 cardinal points (North, South, East. West). Each cardinal point consists of 7 constellations (28/4): The 7 stars traveling across the East are Jia, Geng, Chi, Fang, Xin, Zi and Ge. The 7 stars traveling across the West are Que, Luo, Wei, Mao, Pi, Zui and Sin. The 7 stars traveling across the South are Jing, Gui, Lua, Jing, Zhang, Ju and Chen. The 7 stars traveling across the North are Tou, Yu, Nu, Xu, Niu, Se and Bi. In total, within Heaven, 7 X 4 = 28 constellations (stars) travel. The Fang star located at Mao (4th Terrestrial Branch: 5h-7h) and the Mao star located at You (10th Terrestrial Branch: 17h-19h) are the 2 coordinates that allow the location of Wei (celestial latitude). 396.

The Xu star located at Zi (1st Terrestrial Branch: 23h-1h) and the Zhang star located at Wu (7th Terrestrial Branch: 11h-13h) are the 2 coordinates that allow the location of Jing (celestial longitude). The stars located successively at Mao, Chen, Si, Wu, Wei and Shen (4th, 5th, 6th, 7th, 8th and 9th Terrestrial Branches) are Yang. The stars located successively at You, Xu, Hai, Zi, Chou, and Yin (10th, 11th, 12th, 1st, 2nd and 3rd Terrestrial Branches) are Yin. Ynag of Heaven governs the day, and Yin, the night. In man, Yang governs the 6 bowels, and Yin, the 5 organs. This is why, durng the day, the Wei energy circulates 25 times within the Yang part, and during the night, 25 times within the Yin part of the body. In total, the movements of the Wei energy and the apparent movements of the sun are parallel and obey the same Yin-Yang law.” 2. Recall that the 12 Terrestrial Branches are: 1- Zi (rat) = 23h-1h 2 - Chou (buffalo) = 1h-3h 3 - Yin (tiger) = 3h-5h 4 - Mao (cat) = 5h-7h 5 - Chen (dragon) = 7h-9h 6 - Si (snake) = 9h-11h

7 - Wu (horse) = 11h-13h 8 - Wei (goat) = 13h-15h 9 - Shen (monkey) = 15h-17h 10 - You (cock) = 17h-19h 11 - Xu (dog) = 19h-21h 12 - Hai (pig) = 21h-23h.

b) We present below a table of distribution of the 28 constellations at the level of the 4 cardinal points and two figures of the distribution of the 28 constellations within the celestial vault/canopy√: one according to the Neijing and the other established by Chamfrault and ourselves.

Table 1: Distribution of the 28 constellations within the 4 cardinal point.

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EAST and the name of the stars

SOUTH and the name of the stars

WEST and the name of the stars

NORTH and the name of the stars

1 - Jia

Jing

Que

Tou

2 - Geng

Gui

Lou

Yu

3 - Chi

Lua

Wei

Nu

4 - Fang

Jing

Mao

Xu

5 - Xin

Zhang

Pi

Niu

6 - Zi

Ju

Zui

Se

7 - Ge

Chen

Sin

Bi

397.

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Figure 1: Distribution of the 28 constellations (according to the Neijing).

PARAGRAPH 2

Figure 2: Distribution of the 28 constellations (according to Chamfrault). 398.

“This is why, at daybreak, after having completed 25 passages within the Yin, the Wei energy emerges at the level of the eye. As soon as one opens his eyes, it begins to circulate. (Bl),

1- From the internal canthus of the eye, it spreads toward the Foot taiyang

_ reaches the head _ and descends the nucha and back to the external tip of the little toe (where the point Zhiying- Bl 67 is found). 2- From the external canthus of the eye, it spreads toward the bottom and

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follows the path of the Hand Taiyang (SI), _ reaches the shoulder _ and descends the forearm to the external tip of the little finger (where the point Shaoze- SI 1 is found). 3- From the external canthus of the eye, it spreads toward the path of the Foot Shaoyang (GB), _ descends toward the shoulder _ is directed toward the foot _ and reaches the interdigital space of the 4th and 5th toes and ends at the external tip of the 4th toe (where the point Qiaoyin- GB 44) is found). 4- From the external canthus of the eye, it is directed toward the path of the Shaoyang (SJ), _ descends toward the shoulder _ reaches the arm _ and ends at the external tip of the ring finger (where the point GuanchongSJ 1 is found). Hand

5- From the external canthus of the eye, it spreads in front of the ear, _ reaches the region belonging to the point Chenqi (St 1) _ arrives at the region of the point Jiache (St 6) _ follows the path of the Foot Yangming (St) _ and descend toward the external tip of the 2nd toe (where the point Lidui- St 4 5 is found). 6_ _ _ _ the

From the back of the ear, it spreads toward the sub-auricular region, reaches the path of the Hand Yangming (LI) arrives at the shoulder and arm reaches the side the thumb and penetrates into the palm of the hand. 399.

7- When it reaches the foot, it also penetrates into the sole, then it exits via internal malleolus, _ reaches the Yin region (Foot Shaoyin- Ki) _ reascends toward the top _ and flows into the eye. It forms in this way a “Zhou” ( 3 ) . ”

EXPLANATIONS AND COMMENTARIES N.V.N.: This paragraph concerns the circulation of the Wei Qi during the day at the level of the Yang part of the body. Its trajectory takes off from the Foot Taiyang (Bl), passes via the 6 bowels and arrives at the Foot Shaoyin (Ki). 1- The Foot Taiyang (Bl) starts at the point Jingming (Bl 1). This point of departure explains why it ia said: “At daybreak, the Wei energy manifests at the eye”. In effect, the eye is the site of gathering of the energy of the “good descendents/lineage lignee” or Tong Mai (designating the Ying, Wei and Jing energies). When the Jing of the 5 organs and 6 bowels reunites at the eye, it transforms into ocular Jing (Jing Ming). This is why, at daybreak, when Yin comes to an end, Yang arrives and the eyes open up.

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Upon the opening of the eyes, the Wei energy spreads to the cranium via the path of the Foot Taiyang (Bl), runs along the nucha, arrives at the back and descends to the foot to the point Zhiyin- Bl 67. 2- The circulation of Wei energy does not follow the circadian rhthym like the Ying Qi does. It starts at the internal canthus of the eye, where the point Jingming Bl 1 occurs, in order to spread, without penetrating, to the paths of the Foot Taiyang (Bl). Then it begins to appear at the external canthus of the eye, where the point Tongziliao- GB 1 is found, to reach, without penetrating, the paths of the Foot and Hand Shaoyang (GB and SJ) and toward the Foot and Hand Yangming (St and LI). 3- The Hand Yangming (LI) possesses a secondary vessel which penetrates into the ear and then returns to the principal channel located in the subauricular region where the point Futu (LI 18) is found... . It is this route that the Wei energy diffuses to, up to the point Shangyang (LI 1). 4- Via the route of the Foot Yangming (St), the Wei energy reaches the dorsal surface of the foot, penetrates iinto the sole and exits from the internal malleolus where the point Shaohai (Ki 6) is found belonging to the Foot Shaoyin (Ki). From this point, the Wei energy reaches Jingming (Bl 1) via the path of the Yinqiao curious channel and completes one cycle or “Zhou”. 400.

In conclusion, the circulation of Wei energy is carried out during the day in the Yang part of the body to which it must join the Foot Shaoyin (Ki) in order to accomplish one Zhou. In effect, in Chapter 71 of this classic (“Perverse Guest”), we read: “The Wei Qi (defensive energy), fiery and agile energy, originating from the Cereal Water (Shui Gu), circulates first in a continuous fashion within the epidermo-dermal space and the zone of distribution of the flesh (Fen Ru: space sparating dermis and muscle). During the day, it circulates within the Yang part, and at night, within the Yin part of the body, generally in the region belonging to the Foot Shaoyin (Ki) before following the circuit of the 5 organs and 6 bowels.” In other words, during one day and one night, in order to circulate, the Wei energy cannot be separated from the Foot Shaoyin (Ki). This phenomenon is explained by the fact that the Ben (Root) of man is none other than the Jing and Qi. 3. Circuit, cycle.

• Qi (energy) is Yang, and Yang comes from Yin; Jing (quintessence) is Yin, and Yin comes from Yang. • Ying Qi, by its origin, is Yin. It must inevitably follow the lung to descend. The reason for the exteriorization of Wei energy from the Xiajiao (Lower Jiao) is then clear. The kidney responds to Water, and Water is the root of the energy. This is why Upper Qihai (Upper Sea of Energy) is found at Tanzhong (CV 17) and Lower Qihai (Lower Sea of Energy) is found at the Dan Dian (infraumbilical zone). Therefore, the kidney and lung are the fundamental bases of Yin and Yang.

PARAGRAPH 3 “This is why, _ when the sun Zhou (precisely 50/28 _ when the sun 6.3 Zhou; _ when the sun in 1.8 X 3 = 5.4 Zhou’ _ when the sun

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is displaced one She ( 4 ) , the Wei energy travels the body in 1.8 = 1.785 cycles); is displaced 2 She, the Wei energy travels the body in 1.8 X 2 = is displaced 3 She, the Wei energy travels the body is displaced 4 She, the Wei energy travels the body in 1.8 X 4 =

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7.2 Zhou; _ when the 9.0 Zhou; _ when the 10.8 Zhou; _ when the 12.6 Zhou... ; _ and when X 14 = 25.2 Zhou.

sun is displaced 5 She, the Wei energy travels the body in 1.8 X 5 = sun is displaced 6 She, the Wei energy travels the body in 1.8 X 6 = sun is displaced 7 She, the Wei energy travels the body in1.8 X 7 = the sun is displaced 14 She. the Wei energy travels the body in 1.8 401...

It is, in this manner, that the Yang ends at the Yin and that the Yin begins to receive the energy.

the

• When the energy reaches the Yin, _ from the Foot Shaoyin (Ki), it passes to the kidney _ from the kidney, it passes to the heart _ from the heart, it passes to the lung _ from the lung, it passes to the liver _ from the liver, it passes to the spleen _ and from the spleen, it passes to the kidney to end one Zhou (that is, 25 Zhou during the night as for the Yang part during day).

• To 25 Zhou during the night, one must also add 0.2 (see above) as 0.4 is the number for 1 day and 1 night. As a consequence, the “sleep/wake” cycle in man, late or early, takes into account these surplus√ numbers.” 4. “Star” or unit of measure of solar movement (of one constellation or the other) = solar degree.

EXPLANATIONS AND COMMENTARIES N,V.N.: This paragraph involves the 25 diurnal and 25 nocturnal cycles of the Wei energy. During the day, it circulates at the level of the 3 Yang (Taiyang, Shaoyang, Yangming) and ends up at the Foot Shaoyin (Ki) where it completes the cycle (Zhou). During the night, from the Foot Shaoyin (Ki), it passes to the kidney organ and circulates following the inhibitory chains of the “5 Movements”. We present below a diagram of the circulation of Wei energy at the level of the 3 Yang and at the level of the 5 organs (Figure 3).

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402.

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Figure 3: Circulation of the Wei energy at the level of the 3 Yang and 5 organs (according to the law of the 5 Movements).

PARAGRAPH 4

401...

Huangdi: “Within the organism, Wei energy carries out movements of “ascent/descent - departure/arrival” which are not always the same. How can one determine these to practice acupuncture?” 403.

Qi Bo:

“The celestial movements are in excess or insufficiency, and the days can be long or short. The length of the days is determined by the movements of “ g r o w t h / d e c l i n e ” of the 4 seasons ( 5 ) , and the start of the circulation of Wei energy, by the end of the night. In one day and one night, the water of the clepsydra seeps out 100 Ke ( 6 ) , and 25 Ke represents a half day of one continuous d a y √ . The days, from morning to night, are long or short. The rule of needling depends on all this√ . One must respect the Time in order to determine the period of treatment because the “100 Diseases” apart from time and season are difficult to cure. This is why it is said: “To treat the emptiness, one must use the method of pursuit to tonify”. This advice concerns tonification and dispersion performed before or after the arrival of the energy. One must therefore determine the emptiness or fullness of the energy in order to apply an appropriate treatment. This method of waiting to establish the localiztion of the energy also bears the name “Fung She” (propicious moment) . In other words, if the disease occurs at the 3 Yang channels,

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one must wait for the energy to be well/clearly√ in the Yang zone in order to needle. It is the same for diseases located at the 3 Yin channels; one must wait for the arrival of the energy in the Yin zone in order to needle.”

EXPLANATIONS AND COMMENTARIES N.V.N.: This paragraph emphasizes tonification and dispersion, techniques of acupuncture whose definition is found in Chapter 3 (“Explanations and the Little Needles”) of this classic:

“_ “To render the emptiness into fullness” signifies that it is necessary to apply the technique of tonification in the case of emptiness of Qi Kou (moiuth of the energy: radial pulse). “To excrete what is full” indicates that one must apply the technique of dispersion in the case of fullness of Qi Kou; _ “To eliminate the compressions” is to dissolve the stagnation of perverse energy the Jingmai. “To render the fullness into emptiness” is to disperse the perverse energy situated within the channel in fullness;

within

5. During the spring and autumn equinox, the days and nights have the same duration. But from winter solstice, the days begin to get longer and the nights shorter, and from summer solstice the days begin to get shorter and the nights longer. 6. Unit if time in Huangdi’s era.

_ “First slow, then rapid is to render full” implies slow implantation and rapid removal of the needle (in the case of tonification). “First rapid then slow is to render empty” implies rapid implantation and slow removal of the needle (in the case of dispersion); _ “To speak of emptiness and fullness like to be or not to be” means to say that one must speak of fullness when the energy is present and of emptiness when the energy is absent. “To examine before and after like to lose or not to lose” means to say one must determine the emptiness and fullness of the energy to apply in the first place or in the second place tonification or dispersion and examine for the regression or persistence of the energy; 404.

_ ”This is emptiness, this is fullness, like gain and loss” signifies that during tonification, the individual quivers as if he gained something, and during dispersion, he jumps as if he lost something.”

PARAGRAPH 5 “When

the

clepsydra

_ 1 Ke of outflow, Taiyang (Bl and SI) _ 2 Ke of outflow, Shaoyang (GB and SJ) _ 3 Ke of outflow, Yangming (St and LI) _ 4 Ke of outflow,

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indicates:

the Wei energy of man is found in the Foot and Hand the Wei energy of man is found in the Foot and Hand the Wei energy of man is found in the Foot and Hand the Wei energy of man is found in the Yin part and

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circulates within the Foot Shaoyin (Ki) _ 5 Ke of outflow, the Wei energy of man is found in the Foot and Hand Taiyang (Bl and SI) _ 6 Ke of outflow, the Wei energy of man is found in the Foot and Hand Shaoyang (GB and SJ) _ 7 Ke of outflow, the Wei energy of man is found in the Foot and Hand Yangming (St and LI) _ 8 Ke of outflow, the Wei energy of man is found in the Yin part and circulates within the Foot Shaoyin (Ki) _ 9 Ke of outflow, the Wei energy of man is found in the Foot and Hand Taiyang (Bl and SI) _ 10 Ke of outflow, the Wei energy of man is found in the Foot and Hand Shaoyang (GB and SJ) _ 11 Ke of outflow, the Wei energy of man is found in the Foot and Hand Yangming (St and LI) _ 12 Ke of outflow, the Wei energy of man is found in the Yin part and circulates within the Foot Saoyin (Ki) _ 13 Ke of outflow, the Wei energy of man is found in the Foot and Hand Taiyang (Bl and SI) _ 14 Ke of outflow, the Wei energy of man is found in the Foot and Hand Shaoyang (GB and SJ) _ 15 Ke of outflow, the Wei energy of man is found in the Foot and Hand Yangming (St and LI) _ 16 Ke of outflow, the Wei energy of man is found in the Yin part and circulates within the Foot Shaoyin (Ki) _ 17 Ke of outflow, the Wei energy of man is found in the Foot and Hand Taiyang (Bl and SI) _ 18 Ke of outflow, the Wei energy of man is found in the Foot and Hand Shaoyang (GB and SJ) 405. _ 19 Ke of outflow, the Wei energy of man is found in the Foot and Hand Yangming (St and LI) _ 20 Ke of outflow, the Wei energy of man is found in the Yin part and circulates within the Foot Shaoyin (Ki) _ 21 Ke of outflow, the Wei energy of man is found in the Foot and Hand Taiyang (Bl and SI) _ 22 Ke of outflow, the Wei energy of man is found in the Foot and Hand Shaoyang (GB and SJ) _ 23 Ke of outflow, the Wei energy of man is found in the Foot and Hand Yangming (St and LI) _ 24 Ke of outflow, the Wei energy of man is found in the Yin part and circulates within the Foot Shaoyin (Ki) _ 25 Ke of outflow, the Wei energy of man is found in the Foot and Hand Taiyang (Bl and SI). Such is the calculation (timetable) of the circulation of Wei energy during a half day. From the Feng star to the Pi star, one counts 14 stars and 50 Ke of outflow of the clepsydra. The solar cycle, representing a half day, corresponds to the circuit of one star, and the outflow of the clepsydra is about 3 4/7 Ke. The classic, “Da

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Yu”, states:

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“In permanent fashion, the sun is displaced from one star to another, and the energy of man begins to surely circulate at the level of the Foot and Hand Taiyang (Bl and SI). This is why, in the course of the displacement of the sun (from one star to another), the Wei energy successively circulates at the level of the 3 Yang, then within the Yin zone belonging to the Foot Shaoyin (Ki). The cycle is perpetual. The natural world also obeys this rule which, in spite of its complexity, is clear: _ after the end, is the beginning _ after day, is night _ after 100 Ke, other Ke succeed them _ after 50 cycles, the Wei energy begins again... .”

EXPLANATIONS AND COMMENTARIES N.V.N.: We present below: _ two tables of scheduledhoraire movements of the Wei energy (diurnal and nocturnal) _ and a study of the sites of reunion/passage (Qi Jie) of the Ying (nutritive) Qi and Wei (defensive) energy toward a practical goal.

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1- Scheduled movements of the Wei energy a) Table 1: during the day

406.

b) Table 2: during the night

407.

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Ancient Hour

Yang Zone (Yang Channels)

1 Ke 2 Ke 3 Ke 4 Ke

0h 14mn 24s 0h 28mn 48s 0h 43mn 12s 0h 57mn 36s

Taiyang (SI, Bl) Shaoyang (SJ, GB) Yangimng (LI, St) Foot Shaoyin (Ki)

5 Ke 6 Ke 7 Ke 8 Ke

1h 12mn 0s 1h 26mn 24s 1h 40mn 48s 1h 55mn 12s

Taiyang (SI, Bl) Shaoyang (SJ, GB) Yangimng (LI, St) Foot Shaoyin (Ki)

9 Ke 10 Ke 11 Ke 12 Ke

2h 9mn 36s 2h 24mn 0s 2h 38mn 24s 2h 52mn 48s

Taiyang (SI, Bl) Shaoyang (SJ, GB) Yangming (LI, St) Foot Shaoyin (Ki)

13 Ke 14 Ke 15 Ke 16 Ke

3h 7mn 12s 3h 21mn 36s 3h 36mn 0s 3h 50mn 24s

Taiyang (SI, Bl) Shaoyang (SJ, GB) Yangming (LI, St) Foot Shaoyin (Ki)

17 Ke 18 Ke 19 Ke 20 Ke

4h 4mn 48s 4h 19mn 12s 4h 33mn 36s 4h 48mn 0s

Taiyang (SI, Bl) Shaoyang (SJ, GB) Yangimng (LI, St) Foot Shaoyin (Ki)

21 Ke

5h 2mn 24s 5h 16mn 48s 5h 31mn 12s 5h 45mn 36s

Taiyang (SI, Bl) Shaoyang (SJ, GB) Yangming (LI, St) Foot Shaoyin (Ki)

25 Ke 26 Ke 27 Ke 28 Ke

6h 0mn 0s 6h 14mn 24s 6h 28mn 48s 6h 48mn 0s

Taiyang (SI, Bl) Shaoyang (SJ, GB) Yangimng (LI, St) Foot Shaoyin (Ki)

29 Ke 30 Ke 31 Ke 32 Ke

6h 57mn 36s 7h 12mn 0s 7h 36mn 24s 7h 40mn 48s

Taiyang (SI, Bl) Shaoyang (SJ, GB) Yangming (LI, St) Foot Shaoyin (Ki)

33 Ke 34 Ke 35 Ke 36 Ke

7h 5mn 12s 8h 9mn 36s 8h 24mn 0s 8h 38mn 24s

Taiyang (SI, Bl) Shaoyang (SJ, GB) Yangming (LI, St) Foot Shaoyin (Ki)

37 Ke 38 Ke 39 Ke 40 Ke

8h 52mn 48s 9h 7mn 12s 9h 2imn 36s 9h 36mn 0s

Taiyang (SI, Bl) Shaoyang (SJ, GB) Yangming (LI, St) Foot Shaoyin (Ki)

41 Ke 42 Ke 43 Ke 44 Ke

9h 50mn 24s 10h04mn 48s 10h 19mn12s 10h 31mn 12s

Taiyang (SI, Bl) Shaoyang (SJ, GB) Yangming (LI, St) Foot Shaoyin (Ki)

45 K 46 Ke 47 Ke 48 Ke

10h 48mn00s 11h02mn 24s 11h16mn48s 11h31mn12s

Taiyang (SI, Bl) Shaoyang (SJ, GB) Yangming (LI, St) Foot Shaoyin (Ki)

49 Ke 50 Ke

11h 45mn36s 12h00mn00s

22 Ke 23 Ke 24 Ke

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Actual hour

Taiyang (SI, Bl Shaoyin (passage to the Ki-He axis)

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408.

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Table 3: Reunion-meeting points (Qi Jie) of Ying and Wei at the level of upper and lower zones.

Channel

Localization

1. Foot Taiyang (Bl) Area between the heel (Fuyang- Bl 59) √

Lower "reunion" pts. (roots) Fuyang (Bl 59)

Localization

Upper "reunion" pts. (summit)

Ocular zone ("Mingmen")

Jingming (Bl 1)

2. Foot Shaoyang (GB)

Ext. area of the 4th toe ("Shaoyang" region")

3. Foot Shaoyin (Ki)

Area loc. on inner leg betw. Sp 6 & Sp 8

4. Foot Jueyin (Li)

Area betw. Li 2 and Li 4

Zhongfong (Li 4)

Back "shu" area

Ganshu (Bl 18)

5. Foot Yangming (St)

Ext. area of the 2nd toe (Lidui zone)

Lidui (St 45)

Submaxillary area (Renying zone)

Renying (St 9)

6. Foot Taiyin (Sp)

Area loc. betw. Zhongjing (Li 4) and Sanyinjiao (Sp 6)

Sanyinjiao (Sp 6)

Back ":shu" area & sublingual zone

Pishu (Bl 20)

7. Hand Taiyang (SI) Area below ulnar styloid ("Yanglao" zone)

Qiaoyin (GB 44)

Area loc. in front of the ear ("Jong Long")

Tinggong (SI 19)

Fuliu (Ki 7) Jiaoxin (Ki 8)

Back "shu" area and submental zone

Shenshu (Bl 23) Lianquan (CV 23)

other?

Yanglao (SI 6)

Area above Jingming

New point (PN 1)

8. Hand Shaoyang (SJ)

Interphalangeal area (4th/5th finger) ext. to internal part of the tip of 4th finger

Yemen (SJ 2)

Area of the external canthus of the eye

Sizhukong (SJ 23)

9. Hand Yangming (LI)

Area loc. betw. elbow (LI 11) & the point Binao (LI 14)

Quchi (LI 11) Binao (LI 14)

Frontal area below ear (Touwei zone)

Touwei (St 8)

10. Hand Taiyin (Lu)

Area of the "inch" pulse

Taiyuan (Lu 9)

Brachial area inside and at the level of Binao (LI 14)

Tianfu (Lu 3)

11. Hand Shaoyin (He)

Area loc. on int. edge of pisiform on flexion crease of the wrist ("Shenmen" zone)

Shenmen (He 7)

Back "shu" area

Xinshu (Bl 15)

12. Hand Jueyin (XB)

Area loc. betw. 2 tendons at middle of ant. crease of wrist ("Daling" zone)

Area loc. in 4th intercostal space 1 distance outside the breast

Tianchi (XB 1)

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Daling (XB 7)

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2- Sites of reunion and passage of Ying energy and Wei energy:

409.

Since Wei and Ying energy circulate differently, they become reunited at very specific places. Each principal channel therefore has two very distinct points of reunion, one located down below called “root” (Ben) and another above called “summit” (Jiao). The lower zones (roots) and upper zones (summits) can be in a state of emptiness or fullness. According to Chapter 52 (“Defensive Energy”) of the Lingshu: “The root is found down below. The emptiness of the root becomes expressed as an emptiness of Yang energy, hence sensation of cold. The fullness of the root is caused by perverse heat, hence sensation of heat. The summit is found at the top. The emptiness of the summit immobilizes the Yang (Wei) energy which cannot ascend, hence vertigo. The fullness of thr summit is caused by perverse fever provoking a painful sensation of heat. This is why: _ in the event of fullness, one must use the method of dispersion to undermine the perverse energy. One stops the evolution of the disease in this manner; _ in the event of emptiness, one must use the method of tonification to make the energy of the body, in a state of immobilization, circulate.” In order to pass from a lower zone toward the upper zone, the energy must cross a zone of transit (Qi Jie) located in the thorax, abdomen or on the lower limb; this zone of transit can also be in a state of emptiness or fullness. In effect, always according to the Lingshu, in the same chapter, one reads: _ “Each part of the body has a very specific energetic zone of transit to which one applies treatment by acupuncture according to the energetic disturbances of the corresponding zone. In this manner, to stop the evolution of the disease localizing: _ at the head, one must use the point of the cranial region (Bahui- GV 20); _ at the thorax, one must use the points of the upper part of the thorax and the Back Shu points between the 1st aqnd 2nd dorsal vertebrae; _ at the abdomen, one must use the Back Shu points between the 7th dorsal vertebrae and the lumbosacral region and the points belonging to the Chongmai and the “moving vessels” located at the two sides of the umbilicus (Huangshu- Ki 16 and Tianshu- St 25); _ at the lower limbs, one uses the point Qichong (St 30), located to the side of the artery of the groin crease, and the point Chengshan (Bl 57), at the middle of the calf.” 410.

The significance of these neuralgic points of these three different zones (upper, lower and transit) lies in the treatment of diseases due to disturbances of the energy of the cephalic, thoracic, abdominal and lower limb regions. One must use the “Hao” type needles. Before needling, one must exert pressure on the point used for a long time and wait for the De Qi (arrival of the energy) under the finger; the physician then gets a specific objective sensation. The points belonging to the zones of transit must be needled as a function of the clinical signs: _ headache _ vertigo _ syncope _ abdominal pain _ upset stomach with flatulence _ illnesses of energetic storage. Always according to the Lingshu (Chapter 52): “If the pain is erratic, the spot of blood stagnation has not formed; the disease

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can easily be treated. If the blod stagnation has a form but without painful component, the disease is chronic. The treatment is not always effective.”

3-

In

conclusion: • The circulation of the energy obeys the law of Yin-Yang and is divided into: _ extenal (Yang) circulation and _ internal Yin) circulation.

• These timetables horaires of arrival and departure permit application of needling according to the energetic principles of Chinese medicine. • These sites of reunion between the Ying (nutritive) and Wei (defensive) energies and these sites of transit are grouped together as specific points in the treatment of diseases due to disturbances of the energy and not of the blood. These important ideas represent one path of current research on the components of chronobiolgy and data on the true acupuncture techniques that furnish them√√.

Notes: The Qi Jie points above are drawn from Chapter 52 (“Defensive Energy”) of the Lingshu. The other groups of Qi Jie points are cited in different chapters: 18 (“Production and Reunion of Ying and Wei”), 52 (“Defensive Energy”), 80 (“Great Confusions√”)... of this classic.

410.

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CHAPTER LXXVII 9 Palaces - 8 Winds (Jiu Gong Ba Feng)

Chapter 77 of the Lingshu speaks on the location of “Tai Yi” (supreme unity: polar star). During the year, Tai Yi perodically moves/displaces/shifts√ toward the 8 cardinal points (North, South, East, West, Northeast, Southeast, Northwest and Southwest) and the “9 Palaces” (or Gong which are: Qian, Kan, Gen, Zhen, Xun, Li, Kun, Dui and center). Each cardinal point is the site of distribution of 3 climatic energies (or 3 energetic divisions) during 46 days (or thereabouts), that is 3 X 8 = 24 energetic divisions (cf. further on) for the 8 cardinal points during the year (about 365 days). The day of displacement of Tai Yi, from one palace to another, is also the day of exchange of the climatic energy. If, on the day of exchange, or else several days before or after this day, there is an atmospheric change, based his on this phenomena one can determine the state of the wind and rain in order to predict the seriousness or benignity of the disease. This chapter also addresses the “8 Winds” (Ba Feng) coming from the 8 cardinal points. These 8 winds are grouped together into: _ Shi Feng (true winds) which agree with thetemps weather and have the function of maintaining the development of reproduction of beings and things; _ Xu feng (false winds) which are in opposition to thetemps weather and destroy beings and things. This is why our old masters established the method aimed at protecting against diseases (prophylaxis) based on the “9 Palaces-8 Winds” (9 Gong-8 Feng)√. This chapter contains 4 paragraphs.

PARAGRAPH 1

412.

“ Tai Yi (Supreme Unity: Polar Star) becomes displaced from Dong Zi (winter solstice: 21st or 22nd of December) in order to seek dwelling in the

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Ye Zhe (mass of leaves) palace during 46 days. The following day (47th), it seeks dwelling in the Tian Liu (celestial palace for 46 days.

depot)

The following day, it remains at the Shang Men (door of the warehouse) palace for 46 days. days.

The following day, it seeks dwelling in the in Luo (Yin path) palace for 45 413.

The following day, it lies in the Xuan Wei (true depthprofondeur palace for 46 days. days. days.

conforme)

The following day, it lies in the Shang Guo (gathering of fruits) palace for 45 The following day, it seeks dwelling in the Xin Luo (new path) palace for 45

The next day it returns to the Ye Zhe (mass of leaves) palace, that is to say, at the Dong Zi (winter solstice) palace to begin the cycle again.”

EXPLANATIONS AND COMMENTARIES N.V.N.: This chapter gives us a table of the “9 Palaces” in order to explain the “8 Winds” (Ba Feng) coming from the 8 cardinal directions. a- The orientation of the 9 Palaces is based on the localization of the Ba Gua (8 “Marvels” or 8 Trigrams) which are Qian, Kan, Gen, Zhen, Xun, Li, Kun and Diu. b- The localization of these “marvels” (trigrams) is based on the nature of the 5 Movements arranged at the sides of the 8 cardinal points. In this manner, _ _ _ _ _ _ _ _

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Kan = 1 responding to Water, located to the North Li = 9 responding to Fire, located to the South Zhen = 3 responding to Wood, located to the East Xun = 4 responding also to Wood, located to the Southeast Diu = 7 responding to Metal, located to the West Qian = 6 responding also to Metal, located to the Northwest Kun = 2 responding to Earth, located to the Southwest Gen = 8 responding also to Earth, located o the Northeast.

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Figure 1: The 9 Palaces (Original figure from the Lingshu)

c- According to the characteristics of Yin-Yang and the 5 Movements, each “marvel” (trigram) responds to one atmospheric energy. In this way, for example: _ Zhen located to the East (Wood) responds to Chun Fen (spring equinox: March 21st) _ Li located to the South (Fire) responds to Xia Zi (summer solstice: June 21st or 22nd) _ Diu located to the West (Metal) responds to Qiu Fen (autumn equinox: September 23st) _ Kan located to the North (Water) responds to Dong Zi (winter solstice: December 21st or 22nd), etc. (cf Figure 1) 414. d- The displacement of Tai Yi (from one Palace to another) always brings about an atmospheric change of the 4 seasons and 8 periods of the year, a change characterized by favorable or unavorable movements of the Wind (Shi Feng or Xu Feng), extremely important factors in pathology. Zhang Jing Yue clarifies for us:

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“Tai Yi remains in each palace for 46 days except in 2 palaces, Qian and Xun where it only stays for 45 days. In effect, 1- Ye Zhe is the palace of Kan (square 1). It governs for 46 days the following 3 periods: _ Winter Solstice (Dong Zi) _ Slightly Intense Cold (Xiao Han) _ Great Cold (Da Han). 2- Tian Liu is the palace of Gen (square 8). It governs for 46 days the following 3 periods: _ Beginning of Spring (Li Chun) _ Fine Rain (Yu Shu) _ Awakening of Worms and Microbes (Jing Zhe). 3- Shang Men is the palace of Zhen (square 3). It governs for 45 days the following 3 periods: _ Spring Equinox (Chun Fen) _ Pure Light (Quing Ming) _ Showers of Spring (Gu Yu). 4- Yin Luo is the palace of Xun (square 4), It governs for 45 days the following 3 periods: _ Beginning of Summer (Li Xia) _ Beginning of the Time of Floods (Xia Man) _ Beginning of the Time of Sowing (Mang Zhong). 5- Shang Tian (also called Tian Gong: Celestial Palace) is the palace of Li (square 9). It governs for 46 days the following 3 periods: _ Summer Solstice (Xia Zi) _ Moderate Heat (Xiao Shu) _ Great Heat (Da Shu). 6- Xuan Wei is the palace of Kun (square 2). It governs for 46 days the following 3 periods: _ Beginning of Autumn (Li Qiu) _ Dry Heat (Chu Shu) _ Thick Fog (Bai Lu). 415.

7- Shang Guo is the palace of Diu (square 7). It governs for 46 days the following 3 periods: _ Autumn Equinox (Qiu Fen) _ Thick and fresh Fog (Han Luo) _ Dew Falling (Shuang Jiang). 8- Xin Luo is the palace of Qian (square 6). It governs for 45 days the following 3 periods: _ Beginning of Winter (Li Dong) _ Light Snow (Xiao Xue) _ Heavy Snow (Da Xue). In all, Tai Yi becomes displaced at the level of the 8 Palaces for 365 (46+46+46+45+46+ 46+46+45) days to fulfill its annual cycle. This is why the palaces are 9 in number, but we only describe 8 (the central palace, Zhong Gong, square 5, being governed by Tai Yi itself).

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PARAGRAPH 2 “Tai Yi is displaced on the Dong Zi day (winter solstice) to enter into the Ye Z h e (mass of leaves) palace; from there, one calculates the day of its arrival into the other palaces. In other words, from the number 1 (number of the Kan palace), Tai Yi progressively passes to the number 9 (number of the Li palace), then it returns to the number 1 (number of the Kan palace). The cyclic movements of Tai Yi are perpetual. At the end of the cycle,

EXPLANATIONS AND COMMENTARIES N.V.N.: Each palace (Gong) possesses a number called “number of Luo Shu”, a number which represents the different phases of atmospheric change of the 4 seasons and the luminous force of the day. they are grouped together at/withaux the 4 cardinal points, namely: _ left (East) = 3 _ top (South) = 9 _ right (West) = 7 _ bottom (North) = 1 (see tableau)√?. 416. 1- The numbers are classified into Yang (odd) and Yin (even), The association of Yang (1) and Yin (2) gives: 1 + 2 = 3. The number 3 and its multiples express the number of the 4 cardinal points, therefore, _ the number of the Zhen palace of the east is 3 _ 3 multiplied by 3 = 9, unitary number which represents the Li palace of the South _ 9 multiplied by 3 = 27 _ 27 - (10 + 10) = 7, unitary number of the Diiu palace of the West _ 7 multiplied by 3 = 21 _ 21 - (10 + 10) = 1, unitary number of the Kan palace of the North _ 1 multiplied by 3 = 3, untiary number of the Xhen palace of the East. In other words, the movements of the Yang (odd) numbers are cyclic. 2- The numbers replying to/?restarting atrepartir the 4 cardinal points (North, South, East, West) are all unitary numbers called “Curious Numbers” or Yang numbers. They represent day, sunrise (in the East) and sunset (in the West). In addition, these numbers express atmospheric changes (cold, heat) of the 4 seasons and the radiant strength of the day. Therefore, to the East is the Zhen palace where Chun Fen (spring equinox) occurs; the number 3 represents the moderate heat (Wen or “warm” energy) of spring. This warm energy fo spring, at its maximal phase, becomes transformed into heat. This becomes displaced toward the South to the Li palace whose number 9 represents Xia Zi (summer solstice), that is to say, maximal heat. Maximal heat becomes transformed into coolnessfraicheur. This becomes displaced toward the West to the Diu palace whose number 7 represents Qiu Fen (autumn equinox), that is to say, maximal coolness√. Maximal coolness√is transformed into cold. This is displaced toward the North to the Kan palace whose number 1 represents Dong Zi (winter solstice), that is to say, maximal cold. Maximal cold is transformed into moderate heat (Wen: warm). This returns to the East to the Zhen palace whose number 3 represents the maximum moderate heat of spring.

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These atmospheric movements therefore are cyclic and perpetual.

3- As for daily temperature, the number 3 represents the first glimmer of the sun (dawn). From the number 3, this luminous force gradually is displaced toward the number 9, that is to say, toward the middle of the day (noon) to reach its maximal potential. Then progressively it carries out movements of rotation toward the number 7, that is to say, toward afternoon, slowly growing weaker. The number 1 represents night (midnight) whose luminous force is the weakest (see Figure 2). 417.

Figure 2 4- The 4 angles mentioned in the table of the Lingshu (see above) each possess an even number (Yin) called “occaisional number” whose orientation/movement is opposite to that of the odd (Yang) number. The Yin number starts with 2, that is to say, to the Southwest at the Kun palace. _ 2 multiplied by 2 = 4, occaisioanl number of the Xun palace located to the Southeast. _ 2 multiplied by 4 = 8, occaisonal number of the gen palace located to the Northeast. _ 2 multiplied by 8 = 16 _ 16 - 10 = 6, occaisional number of the Qian palace located to the Northwest _ 2 multiplied by 6 = 12 _ 12 - 10 = 2, occaisional number of the Kun palace located to the Southwest.

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In other words, the movement of the numbers are cyclic (see Figure 3).

Figure 3 418.

In this way, the movement of the occaisional (Yin) numbers, like those of the “curious (Yang) numbers”, can represent energetic variations of the 4 seasons and the change in luminous strength of the day in order to explain the phenomena of departure/arrival of the cold and heat, of day and night.

5- The essential point is the number 5 noted in the center of the table of the 9 Palaces (Figure 1) because it is considered as the base of development of all the numbers. In effect, it is sufficient to compare it with the numbers mentioned in the squares of the table of the 9 Palaces (see Figure 1 and Paragraph 1) in order to have an astonishing meaning√. In fact, a- The Yin number (even) 2 multipied by 5 = 10. This number 10 recurs when one adds the numbers of the squares of the 8 cardinal points: _ 9 (Top/South) + 1 (Bottom/North) = 10 _ 3 (Left/East) + 7 (Right/West) = 10 _ 4 (Southeast) + 6 (Northwest) = 10 _ 2 (Southwest) + 8 (Northeast) = 10. b- The Yang (odd) number 3 multiplied by 5 = 15 This number 15 recurs when one adds the numbers of the 3 vertical, 3 horizontal and the 2 diagonal squares.

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• 3 horizontal squares: _ 4 + 9 + 2 = 15 _ 3 + 5 + 7 = 15 _ 8 + 1 + 6 = 15 • 3 vertical squares: _ 4 + 3 + 8 = 15 _ 9 + 5 + 1 = 15 _ 2 + 7 + 6 = 15 • 2 diagonal squares: * Southeast/Northwest squares: _ 4 + 5 + 6 =15 * Southwest/Northeast squares: _ 2 + 5 + 8 = 15 (see Figure 4). c- The Yin (even) numbers (2 + 4 + 6 + 8) multiplied by 5 gives the number 100. d- The Yang (Odd) numbers (1 + 3 + 5 + 7 + 9) multiplied by 5 give the number 100. 419.

PARAGRAPH 3

Figure 4: The “9 Palaces” and “9 Numbers”.

“The days of displacement of Tai Yi (Supreme Unity) are always followed by atmospheric changes: rains and winds. If the rains and winds take place the same day of its displacement, it is favorable; the monsoon is abundant, the people are at peace and diseases are rare. If the rains and winds take place before the day of displacment, abundant rains precede and marked dryness follow. _ During the sojourn of Tai Yi at Dong Zi (winter solstice), when there are atmospheric changes, it occupies the place of the King. During the sojourn of Tai Yi at Chun Fen (spring equinox), when there ar

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atmopsheric During atmopsheric During atmospheric

changes, it occupied the the sojourn of Tai Yi at changes, it occupies the the sojourn of Tai Yi at changes, it occupies the

place of the Minister. Zhong Gong (Central Palace), when there are place of the Mandarin. Xia Zi (summer solstice), when there are place of the people.

Called energetic modifications, disturbances take place on the day of passage of Tai Yi within one of these 5 palaces noted like the wind which breaks branches, raises sand and stone. Based on these phenomena, we follow the displacements of Tai Yi to determine seriousness or benignness of disease; we observe the direction of arrival of the wind to evaluate prognosis. 420.

The wind coming from the opposite direction opposite to the sejourn of Tai Yi is named “Xu Feng” (False Wind), a very harmful wind to beings and things, a wind very evil and very, very deadly. This is why one must know how to predict Xu Feng to avoid disasters and diseases. The sages avoid False Wind (Xu Feng) as they would a stream of arrows and stones. Therefore,

perverse

energy

does

not

succeed

in

injuring

their

health.

Such is the true meaning of eugenism.”

EXPLANATIONS AND COMMENTARIES N.V.N.: This paragraph is divided into 2 parts: 1- Prognosis during displacement of Tai Yi 2- Introduction to the study of Shi Feng and Xu Feng.

PARAGRAPH 4 “This is why, when Tai Yi occurs in the Central Palace (Zhong Gong), it can become directed toward the sides of the Ba Feng (8 Winds) in order to determine harmful or propserous meteorologic phenomena. 1- Wind coming from the South is called “Da Ruo Feng” (very weak wind). When it attacks man, it infiltrates deeply into the interior to lodge in the heart, and, at the exterior it penetrates into the vessels (channels), its energy governs the diseases of Heat (Re). 2- Wind coming from the Southwest is named “Mu Feng” (cunning wind). When it attacks man, it infiltrates deeply into interior to lodge in the spleen, and, at the exterior, it penetrates into the flesh (dermis). Its energy governs deficiencies (Ruo).

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3- Wind coming from the West is called “Gang Feng” (powerful wind). When it attack man, it infiltrates deeply into the interior to lodge within the lung, and, at the exterior, it penetrates into the skin (epidermis). Its energy governs the diseases of dryness (Zao). 421.

4- Wind coming from the Northwest is called “Zhe Feng” (destructive wind). When it attacks man, it infitrates deeply into the interior to lodge within the small intestine, and, at the exterior, it penetrates into the Hand Taiyang (SI). The exhaustion of this vessel expresses as an overflowing of perverse energy, and its obstruction, by a stoppage of energetic circulation able to provoke sudden death. 5- Wind coming from the wind). When it attacks man, it the kidney, and, at the exterior, rows of paravertebral muscles).

North is named “Da Gang Feng” (extremely powerful penetrates deeply into the interior to lodge within it penetrates into the bones and the 2 Lu Jin (2 Its energy governs the diseases of Cold (Han).

6- Wind coming from the Northeast is called “Xiong Feng” (brutal wind). When it attacks man, it penetrates deeply into the interior to lodge within the large intestine and, at the exterior, it penetrates into the ribs, under the axilla and within the joints of the upper limbs. 7- Wind coming from the East is named “Yin Er Feng” (child wind). When it attacks man, it penetrates deeply into the interior to lodge within the heart, and, at the exterior, it penetrates into the vessels (channels). It energy governs the sensation of heaviness of the body. 8- Wind coming from the Southeast is called “Ruo Feng” (weakening wind). When at attacks man, it penetrates deeply into the interior to lodge in the stomach, and, at the exterior, it pentrates into the flesh (dermis). Its energy governs the sensation of heaviness of the body.

The “8 Winds” (Ba Feng) noted above all come from the side of “Xu Qi” (false energy, disordered energy). This is why in man, they cause numerous diseases. The association of the 3 Xu Qi: _ Xu Ren: energy of man in a state of emptiness _ Xu Qi: disordered energy of the seasons _ Xu Nian: annual energy in a state of emptiness is the origin of lethal diseases and sudden death.

422.

The ailments caused by 2 Shi Qi (2 true perverse energies) and 1 Xu Qi (false or disordered energy or “Empty Energy”), when they occur in the presence of wind and rain, become transformed into ColdHeat disease (Han Re). In rainy and humid places, these ailments evolve toward the Wei disease (atrophic impotence). This is why, the sages avoid the Wind as one arrows and stones.

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Feng),

The attack of these 3 Xu Qi associated with a direct attack of wind (Zhong always cause collapse, coma and hemiplegia.”

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains: “This paragraph speaks on the different types of Xu Feng (false or empty wind), very harmful to human beings. This study is based on the 8 cardnal points in relationship to Yin and Yang and the 5 Movements in order to explain the importance of the influence of the evolution of the cosmic energy in human beings.

1- The South responds to the Li-Fire palace. When heat comes to manifest, the wind is very weak, hence the name Da Ruo Feng (very weak wind). In man, this wind responds to the Fire organ. In the interior, it reaches the heart, and, at the exterior, it settles in the vessels. Its disease is that of the Heat. In the disease of the heart, it is always the Xin Bao (XB) which is affected. 2- The Southwest responds to the Kun-Earth palace. The Yin energy comes from birth, the Yang energy is found in full phase of fullness. The departure and arrival resemble a discussion (deliberation). It is this wind coming from the Kan palace and named Mu Feng (cunning wind). In man, it responds to the Earth organ. In the interior, it reaches the spleen organ, and, at the exterior, it settles in the flesh (dermis). 3- The West responds to the Diu-Metal palace. The energy of metal is hard (powerful). This is why it has the name Gang Feng (powerful, hard wind). In man, this wind responds to the Metal organ. In the interior, it reaches the Lung, and, at the exterior, it settles in the skin (epidermis). It disease is that of dryness. 423.

4- The Northwest responds to the Qian-Metal palace. Metal governs destruction. This is why its energy bears the name Zhe Feng (destructive wind). During attack of the wind from the South, it lodges at the top, and coming from the North, it settles at the bottom. In our case, it causes disturbances of the Hand Taiyang (SI) because the small intestine, responding to Bing (3rd Celestial Stem), is the fire-bowel of the Xiajiao (Lower Jiao- LJ). Metal responds to the West; its energy is destructive. Water responds to the North; its energy is tragic. The association of these 2 energies is very harmful to the production of the Yang energy; this is why, when it attacks man, it can provoke sudden death. 5- The North responds to the Kan-Water palace. When the energy is cooled down, the wind becomes powerful; this is why it is called Da Gang Feng (extremely violent wind). In man, it responds to the Water organ. In the interior, it reaches the kidney organ, and, at the exterior, it settles within the bones and paravertebral muscles (Lu Jin) belonging to the Foot Taiyang (Bl). As a result, when one treats the kidney, one also treats the bladder. Their energy governs the disease of Cold. 6- The Northeast responds to the Gen-Earth palace. The Yin energy has not yet drawn back/moved backrecule, and the Yang energy is still not found in a phase of fullness. This is why

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this wind is called Xiong Feng (violent wind). In man, it reaches the large intestine because it responds to Geng (7th Celestial Stem) and to Metal and is found in the region of the Xiajiao (LJ). At the exterior, it settles at the joints of the upper limbs at the level of the Hand Yangming (LI). 7- The East responds to the Xhen-Wood palace. The wind arises in the East. This is why it bears the name Ying Er Feng (child wind). In man, it responds to the Wood organ. In the interior, it reaches the liver organ, and, at the exterior, it settles in the tendinomuscular system. When one treats the liver, one also treats the gallbladder. The wind triumphs over humidity. But the Child Wind (Ying Er Feng) can transform into humidity because the Southeast is the dwelling place of water and the site of residence of humidity. This is why, the wind of the East is always accompanied by rain, causal factor of numerous diseases of humidity. 8- The Southeast responds to the Xun-Wood palace. The Yin energy is mild (warm); it causes Ruo Feng (weak wind). At the Southeast, humidity is victorious. It relies on the support of Wood to “defy/scorn” Earth. This is why it can injure the human body. In the interior, it reaches the stomach, and, at the exterior, it settles in the flesh (dermis) system and causes the sensation of heaviness of the body.” 424.

II - N.V.N.: These notions are among the basic elements of diagnosis and therapy of Oriental energetic medicine. For acupuncturists, it is iimpossible to ignore them. For the purpose of research, we present below 2 tables:

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Southeast

Xin Wood

4 Beginning of summer Ruo Feng (weakening wind)

South

Southwest

Li Fire

Kun Earth

9 Summer solstice Da Ruo Feng (very weakened wind)

2 Beginning of Autumn Mu Feng (cunning wind)

East

West

Zhen Wood

Diu Metal

3 Spring equinox Ying Er Feng (child wind)

5 Central Palace

Northeast

North

Gen Earth

Kan Water

1

8 Beginning of Spring Xiong Feng (brutal wind)

1 -

Winter solstice Da Gang Feng (extremely violent wind)

7 Autumn equinox Gang Feng (violent wind)

Northwest

Qian Metal

6 Beginning of winter Zhe Feng (destructive wind)

Table of the “9 Palaces” and “8 Winds”

425.

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5 Movements

Fire

Direction of Wind

South

Name of the Wind

Da Ruo Feng (very weak wind)

Influences

on

man

Interior (Li)

Exterior (Biao)

Diseases

Heart

Vessels

Heat

Earth

Southwest

Mu Feng (cunning wind)

Spleen

Dermal system

Deficiencies (asthenia)

Metal

West

Gang Feng (violent wind)

Lung

Epidermal system

Dryness

Metal

Northwest

Zhe Feng (destructive wind)

Small Intestine

Hand Taiyang

Energetic Destructions

Water

North

Da Gang Feng (extremely violent wind)

Kidney

Bone system Paravertebral muscles

Cold

Earth

Northeast

Xiong Feng (brutal wind)

Large Intestines

Costal system

Articulations of the limbs (?)

Wood

East

Ying Er Feng (child wind)

Liver

Tendinomuscular system

Humidity

Wood

Southeast

Ruo Feng (weakening wind)

Stomach

Dermal system

Sensation of heaviness of body

2 - Table of the “8 Winds” as a function of the 5 Movements

no 426/427.

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CHAPTER LXXVII Dissertation on the "9 Needles" (Jiu Zhen Lun)

Chapter 78 of the Lingshu speaks on the 9 types of needles and their use following the notion of “homogenization” of “Heaven-Earth-Man” in determining pathologic natures as a function of the way of life of the human being in the natural world. The general indications for acupuncture and moxabustion, Qigong, massage, soothingadoucissants remedies and alcoholized remedies are quoted. This chapter also integrates the great fundamental ideas in the application of acupuncture and moxabustion: _ the functions of the 5 organs _ the relationships between Yin and Yang of the human being _ the triggering process of disease of the blood and energy, Yin and Yang. This chapter contains 4 paragraphs.

PARAGRAPH 1 Huangdi: “I have often heard you speak of the “9

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are rich and immense. But I still have not clearly grasped certain aspects. I would liketo ask you what is their origin and what justifies their names?” Qi Bo:

“The “9 Neeldes” are based on the numbers of mutation of the Yin and Yang of Heaven and Earth, whose numbers of beginning is 1 and whose ending number is 9. 428.

This _ 1 _ 2, _ 3, _ 4, _ 5, _ 6, _ 7, _ 8, _ 9,

is why it is said: is the number of Heaven the number of Earth the number of Man the number of the 4 Seasons the number of the 5 Sounds the number of the 6 Lu (6 Resonant Pipest u b e s ) the number of the 7 Stars the number of the 8 Winds the number of the 9 Regions (Ye).”

Huangdi: “How do the needles respond to the number 9?” Qi Bo:

“By calculation, the sages created the numbers of mutation of the Yin and Yang of Heaven and Earth, from 1 to 9, basic numbers from which the “9 Regions” are established. Multiplying 9 by 9, one obtains 81, number of Huang Zhong (Yellow Bell) or “number of universal mutations”. The origin of the 9 Needles also originates from these basic numbers (from 1 to 9). 1- “1” responds to Heaven, to Yang. Among the 5 organs, the lung responds to the number 1, to Heaven and to Yang. It is the “cover/lid√ ” of the 5 organs and 6 bowels. The skin and hair (epidermis) are the sites of reunion of the energy of the lung belonging to the Yang part of the body. This is why the needle, created/ d e s i g n e d ? to puncture and treat, must have a big head with pointed tip authorizing a slightly deep penetration (into the dermis) in order to evacuate only perverse energy. 2- “2” responds to Earth, to Yin. The flesh (dermal) system respond to Earth-Spleen. This is why the needle, created to puncture and treat, must have a body straight as bamboo (Zu) and a well-rounded tip in order not to injure the flesh because injury to this region exhausts the energy of the spleen. 3- “3” responds to Man. Man’s life depend on blood and energy. This is why the needle, created to puncture and treat, must have a large body with rounded tip to be able to “massage” the vessels (without damaging them) and to p o u s s e r move the Zheng Qi (essential energy) to expel the perverse energy. 429.

4- “4” responds to the “4 Seasons”.

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Here, the word “season” implies the “8 Winds” (Ba Feng) coming from the 8 cardinal directions (North, South, East, West + Northwest, Northeast, Southeast, Southwest) of the year (4 seasons). During the 4 seasons, the 8 Winds coming from the 8 cardinal directions can infiltrate into the organism to trigger Liu Bing (refractory diseases). This is why the needles, created to puncture and treat, must have a body straight as bamboo with a pointed and sharp cutting tipt r a c h a n t to disperse the heat (toxic) via evacuation of blood thereby reducing chronic and recurring disease. 5- “5” reponds to the “5 Sounds”. The number 5 represents the center responding to the region belonging to Z i (1st Terrestrial branch: 23h-1h) and to Wu (7th Terrestrial Branch: 11h-13h), region where Yin and Yang are in the process of separating, and cold and heat confront one another. In mixing, these two energies transform into Yung (abscess). This is why the needle, created to puncture and treat, must have a pointed and sharp cutting tip like a sword to incise and evacuate pus. 6- “6” responds to the “6 Lu” (3 resonant Yin and 3 resonant Yang pipes). The 6 Lu harmonizes Yin and Yang of the 4 Seasons with the 12 Jingmai. When Xu Xie (perverse wind) is localized in the channels, it causes Bao Bi (violent obstruction). This is why the needle, created to puncture and treat, must be pointed and thin like a long hair and of relatively large body to chase away Bao Qi (bold energy). 7- “7” responds to the “7 Stars”. The 7 Stars represent the 7 orifices of man: 2 orbital cavities, 2 auricular orifices, 2 nasal orifices and 1 buccal cavity. When Xu Xie (perverse energy) settles within the Jingmai (principal channels), it passes to the Luomai (secondary channels) to trigger Bi Tong (painful blackage). This is why the needle, created to puncture and treat, must be very streamlined like the of the mosquito and used according to the method of awaiting the De Qi (arrival of the energy). The removal of the needle is only carried out upon the arrival of Zheng Qi (essential energy), that is to say, when the Chen Qi (source energy) and Xie Qi (perverse energy) are onder the action of the needle. 430.

8- “8” reponds to the “8 Winds”. The 8 Winds (Ba Feng) represent the 8 joints of the limbs (2 shoulders, 2 elbows, 2 hips and 2 knees). Xu Feng (empty wind) comes from Be Zheng (8 directions: 8 cardinal points). This wind is very harmful to man. it lodges within the joints to trigger Shen Bi (deep bloackage). This is why the needle, created to puncture and treat, must have a long body and very pointed tip to chase away the Xie Qi (perverse energy) concealed within the joints. 9- “9” responds to the “9 Regions” (Ye). Here, the word “regions” implies the epidermal

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articular regions.

When perverse Yin (water) invades the body, it stagnates within the skin causing Feng Shui (wind-water = edema) and within the joints, causing hydrarthrosis. This is why the needle, created to puncture and treat, must have a large body and small, rounded tip to evacuate the water lodged in the skin and joints.”

EXPLANATIONS AND COMMENTARIES N.V.N.: 1- This paragraph involves the origin of the “9 Needles” according to the basic numbers of phenomena of mutation/transformation of Yin and Yang (movement and rest) of the natural world (Heaven-Earth) cited in the ancient claasic, “I Jing” (“Book of Changes”). Envisioned globally, the basic numbers of mutation are divided into: _ odd numbers: 1, 3, 5, 7, 9 among which 9 is the end number _ even numbers: 2, 4, 6, 8, 10 among which 10 is the end number. But 10 = 9 + 1. As a result, the even numbers also start from 1, odd number. This is why, from “1 to 9; 9 X 9 = 81” constitute the numbers of Huang Zhong (Yellow Bell), the basic number of all mutations and transformations of all beings and things in the universe. The “9 Needles” also obey this law. 2- The number 5 and the 5 Sounds. This number occurs in the middle between 1 and 9. Based on the diagram of the “9 Palaces” (9 Gong): _ 1 is found at the Kan palace located to the North and responding to winter solstice and the 1st Terrestrial Branch, Zi (23h-1h). 431. _ 9 is found at the Li palace located to the South and responding to summer solstice and the 7th Terrestrial branch, Wu (11h-13h). But 5 is found in the center, between the Kan and Li palaces (see Figure 1), in the middle of 1 and 9. These two palaces, Kan and Li, respond respectively to winter (Cold) and summer (Heat) and to the Terrestrial Branches Zi and Wu . The formation of Yung (abscess) originates from the opposition of these two energies (Cold and Heat). According to Zhang Jing Yue (1563-1640 A.D.): “The Five Sounds are linked to the 5 Movements responding to the Terrestrial Branches (Tian Gan), hence the existence of the discrimination between Zi and Wu during the distribution of the spatial zones.”

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Figure 1: The number 5 and “9 Palaces” (Chart of the “8 Chants Woods√bois of the Sacred Turtle”: chart of mutations)

PARAGRAPH 2 Huangdi: “On what model are the needles based?” Qi Bo:

“For the first type of needle, the Chen needle, its length is that of Jin Zhen (needle for attaching a turban) from which one has removed the point. It is therefore 1.6 cun. For the second type of needle, the Yuan needle, its length is that of Ru Zhen (needle for quilting). Its body is cylindrical and its tip oval. Its length is 1.6 cun. It treats regions of the “distribution of the flesh” (Fen Ru: dermis). For the third type of needle, the Ti needle, its length is that of the tip of a grain of millet is 3.5 cun. it serves to massage the vessels to increase the potential of the Zheng Qi (essential energy) and to evacuate Xie Qi (perverse energy). For the fourth type of needle, the F e n g needle, its length is that of Ru Zhen (nedle for quilting) like the previous one (needle no. 2). Its body is round and its tip very slender. It treats “heat abscesses” (Yung Re) by evacuation of thickened blood and pus. The fifth type of needle, the F i needle, is modeled after the cutting edge of the sword. It serves to evacuate large pyogenic formations originating from the confrontation of two heats, perverse heat and heat of the body. The sixth type of needle, the L i needle, is modeled after Li Zhen (Li needle). Its point is relatively large and its body thin in order to needle deeply. It is 1.6 cun long and serves to treat Y u n g (abscesses) and Bi ( o b s t r u c t i o n s ) .

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The seventh type of needle, the H a o needle, is modeled after Hao Mao (thin hair). it is 1.6 cun long and serves to treat the Han Re (Cold-Heat) ailments and Tong Bi (painful obstructions) located at the level of the Luomai (secondary vessels). The eighth type of needle, the C h a n g needle, is modeled after Qi Zhen (long needle). it is 7 cun long and serves to treat the Chen Bi (deep obstructions). The ninth type of needle, the Da needle, is modeled after Feng Zhen (cf. needles no. 2 and 4). Its point is slightly rounded. It is 4 cun long. It serves to evacuate water located at the level of the joints (hydrarthosis). In this manner is the study of the “9 Needles”

achieved.

Long or short, pointed or blunt, these needles are made according to very specific rules.”

EXPLANATIONS AND COMMENTARIES N.V.N.: The “9 Needles” mentioned in this paragraph are therefore, by analogy, are reflective of the form, function or length of the needles or instruments in standard use in Huangdi’s time.

433.

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Figure 2: The “9 Needles” of Huangdi’s era.

PARAGRAPH 3 Huangdi: “ I would like to hear from you regarding the relationships between the diferent parts of the body and the “9 Regions” ( Y e ) . ” Qi Bo:

“Your subject would like then to demonstrate to His Majesty the correspondences between the different parts of the body and the 9 Regions. 1- The left foot responds to Li Chun (beginning of spring) and to the days W u Yin (5th Celestial Stem - 3rd Terrestrial Branch) and Ji-Chou (6th Celestial Stem and 2nd Terrestrial Branch). 2- The left hip responds to Chun Feng (spring equinox) and to the days Y i M a o (2nd CS - 4th TB). 3- The left hand responds to Li Xia (beginning of summer) and to the days W u Chen (5th CS - 5th TB) and Ji-Si (6th CS - 6th TB). 4- The thorax, neck, throat, face and head respond to Xia Zhi (summer solstice) and to the day Bing-Wu (3rd CS - 7th TB). 5- The right hand responds to Li Qiu (beginning of autumn) and to the days Wu-Shen (5th CS - 9th TB). 434.

6- The right hip responds to Qiu-Fen (autumn equinox) and to the days X i n You (8th CS - 10th TB). 7- The right foor responds to Li Dong (beginning of winter) and to the days Wu-Xu (5th CS - 11th TB) and Ji-Hai (6th CS - 12th TB). 8- The lumbar region, coccyx and the Yin (uterus and anus) respond to Dong Zhi (winter solstice) and to the days Ren-Zi (9th CS 1st TB). 9- The bowels and the 3 sub-diaphragmatic organs (liver, spleen, kidney) respond to Dong Zu (central abdominal region) whose “great forbidden days” belong to Wu (5th CS) and Ji (6th CS). The “9 Regions” noted above are utilized to determine the localization of the energy of Ba Sheng (8 cardinal points). In this way, for example, in the case of abscess or edema localizing to the left or right, at the

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top or bottom of the body, it is advised to treat by the method of evacuation during these days, days that we call “forbidden celestial days” . ”

EXPLANATIONS AND COMMENTARIES N.V.N.: This paragraph speaks on the correspondences between the “9 Regions” of the body and the “time movements” of the year: _ 2 solstices (winter and summer) _ 2 equinoxes (spring and autumn) _ 4 seasonal beginnings (spring, summer, autumn and winter) _ and 9 days of entrance of Tai Yi (supreme unity) within the central palace of the “9 Palaces-8 “Marvels”. 1- Here, the system of coordination of the human body responding to the “9 Regions” is based on the temporal positions of the “9 Palaces/8 “Marvels” which according to the “I Jing” (“Classic Book of Changes”) are linked to Yin and Yang and to the 5 Movements. This means to say also that the top and bottom, left and right of the human beings is divided into Yin and Yang: _ the top is Yang, and the bottom, Yin _ the left is Yang, and the right, Yin _ Yang govern ascent, and Yin, descent. These components are linked to climatic variations (cold, heat, warmth, coolness), that is to say, to Yin and to Yang, to the emptiness and to the fullness of the 4 seasons allowing explanation of the theory of HeavenEarth-Man. 435.

Therefore, within the year: _ The warm climate of spring and hot climate of summer belong to Yang, and Yang rises up toward the top. This is why, in man, the left (Yang) foot responds to Li Chun (beginning of spring), and the left (Yang) hand, to Li Xia (beginning of summer). _ The cool climate of autumn and cold climate of winter belong to Yin and Yin descends. This is why, in man, the irhgt (Yin) hand reponds to Li Qiu (beginning of autumn), and the right (Yin) foot, to Li Dong (beginning of winter). _ The two lateral parts of the abdomen, to the right and left of the epigastrium (hypochondria), regions located between the hands and feet (upper and lower limbs) are attributed to Chun fen (spring equinox), the period during which day and night have the same duration. This is why it is said: “The left hand responds to Chun Fen, and the right hand, to Qui Fen”. _ Above the lumbar region is the site of reunion of all Yang, and below, the site of reunion of all Yin. In the course of the year, the maximal fullness of Yang energy and longest day take place on the summer solstice (Xia Zhi), and the maximal fullness of Yin energy and the longest night take place on the winter solstice (Dong Zhi). This is why the thorax, neck, head and face respond to Xia Zhi (summer solstice) and the Yin (anus, uterus) respond to Dong Zhi (winter solstice). _ The abdomen occurs at the center (of the body). This is why the 6 bowels and the 3 organs (liver, spleen, kidney) respond to Zhong Gong (Central Palace). 2- The body of man responds to the “9 Regions”; each azimuth (1) is coordinated with the “Celestial Stem” day (Gan Zhi) in relationship to the position of the 8 cardinal points, 10 Celestial Stems (CS) and 12 Terrestrial

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Branches (TB). In this regard, Zhang Jing Yue furnishes us with the following explanations: “Qian (6), Kun (2), Gen (8) and Xun (4) are at the 4 angles: Northwest, Southwest, Northeast, Southeast. Kan (1), Li (9), Zhen (3) and Diu (7) are at the 4 sides: North, South, East, West.” Earth prospers at Si Gui (4 precious sides); as a result, the palace of the 4 angles (Northwest, Soutwest, Northeast, Southeast) respond to Wu-Ji (5th CS - 6th CS). As for the palaces of the 4 sides (North, South, East, West), they each have a preponderant energy appropriate to them. a) The left foot responds to the Gen (8) palace located to the Northeast. In effect, after Li Chun (beginning of spring), the climatic (seasonal) energy corrsesponds to that of the Northeast and to the days Yin (3rd TB) and Chou (2nd TB). Therefore, that of the left foot responds to this energy. 436.

b) The left hypochondria responds to the Zhen (3) palace situated in the East. After Chun Fen (spring equinox), the climatic (seasonal) energy corresponds to that of the East and to the day Yi-Mao (2nd CS - 4th TB). Therefore, that of the left hip responds to that energy. c) the left hand responds to the Xun (4) palace situated in the Southeast. After Li Xia (beginning of summer), the climatic (seasonal) energy corresponds to that ofthe Southeast and to the days Wu-Chen (5th CS - 5th TB) and Ji-Si (6th CS - 6th TB). Therefore, that of the left hand responds to this energy.

1. The arc of the horizon measured clockwise from the south point in astronomy, or from the north point in navigation, to the point where a vertical circle through a given heavenly body intersects the horizon (Random House Webster’s College Dictionary. New York: Random House. 1997.).

d) error in sequence/something missing? The right hand responds to the Kun (2) palace to the Southwest. After Li Qiu (beginning of autumn), the climatic (seasonal) energy corresponds to that of the Southwest and the days Wu-Shen (5th CS - 9th TB) and Ji-You (6th CS - 10th TB). Therefore, that of the right hand responds to this energy. e) The right hypochondria responds to the Diu (7) palace to the West. After Qiu Fen (autumn equinox), the climatic (seasonal) energy corresponds to that of the West to which belongs that of the day Xin-You (8th CS - 10th TB). Therefore, that of the right hip responds to this energy. f) The right foot responds to the Qian (6) palace to the Northwest. After Li Dong (beginning of winter), the climatic (seasonal) energy corresponds to that of the Northwest to which belongs that of the day Wu-Xu (5th CS - 11th TB) and Ji-Hai (6th CS - 12th TB). Therefore, that of the right foot responds to this energy. g) The lumbars, coccyx and 2 Yin (anus, uterus) respond to the Kan (1) palace to the North. After Dong Zhi (winter solstice), the climatic (seasonal) energy corresponds to the North to which belongs that of the day Ren-Zi (9th CS - 1st TB). Therefore, that of the lumbars, coccyx and 2 Yin respond to this energy. h) Zhong Gong (Central Palace) designates the abdomen, that is to say, the 3 organs (liver, spleen and kidney) and the 6 bowels. This is why it is said: “The 3 organs and 6 bowels respond to Zhong Gong”. In this paragraph, the “great forbidden days” designate the days during which Tai Yi (Supreme Unity) occurs at Wu (5th CS) and Ji (6th CS) belonging to Earth responding to the Central Palace (Zhong Gong). The number 9 designates the “9 Palaces” (Gong), and the term “8 Zheng”, the “8 true winds” coming from the 8 cardinal directions, the site where Tai Yi (Supreme Unity) is located during its displacements.

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This true energy of Heaven and Earth govern that of man. This is why it is the “master” of the top and bottom, left and right of the humna body. 437. In this way, in the event of abscesses, for example, it is recommended against to treat during the forbidden days at the risk of provoking an escaping of the source energy (Yuan Qi: essential energy). The “forbidden days” constitute a key chapter in the practice of acupuncture which must be completed by the lecture of Chapter 73 (“Ability in the Practice of Acupuncture”) of the Lingshu and Chapter 23 (“Discourse on the Five Energies”) of the Suwen.

Table of correlations between bodily regions and the "9 Palaces".

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Region of the Body

Responses of Tai Yi

Thorax, neck, head

Summer solstice (XIA ZI)

Prohibited Days

Orientations of the "9 palaces"

Bing - Wu (3rd CS and VIIth TB)

"Li" Palace (South - 9)

Lumbar vertebrae and "2 Yin" (penis+anus)

Winter solstice (DONG ZI)

Ren - Zi (9th CS and Ist TB)

"Kan" Palace (North - 1)

Left hypochondrion

Spring equinox (CHUN FEN)

Yi - Mao (2nd CS and IVth TB)

"Zhen" Palace (East - 3)

Right hypochondrion

Autumn equinox (QIU FEN)

Xin - You (5th CS and Xth TB)

"Diu" Palace (West - 7)

Tai Yu occurs on days "Wu-Ji" (5th-6th CS)

"Center" Palace (Center - 5) "Gen" Palace (Northeast - 8)

3 organs and 6 bowels (abdomen) Left hand

Beginning of summer (LI XIA)

Wu - Chen and Ji - Si (5th CS and Vth TB) & (6th CS and VIth TB)

Right hand

Beginning of autumn (LI QIU)

Wu - Sen and Ji - Wei (5th CS and IXth TB) & (6th CS and VIIIth TB)

"Xun" Palace (Southeast - 4)

Left foot

Beginning of spring (LI CHUN)

Wu - Yin and Ji - Chou (5th CS and IIIrd TB) & (6th CS and IInd TB)

"Qian" Palace (Northwest - 6)

Beginning of winter (LI DONG)

Wu - Xu and Ji - Hai (5th CS and XIth TB) & (6th CS and XIIth TB)

"Kun" Palace (Southwest - 2)

Right foot

PARAGRAPH 4 366

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“1- In the individual whose peaceful Xing (bodily form) is associated with an unwell Jing Shen (mental), the disease generally manifests at the Jingmai (principal channels). Therapeutically, moxabustion is absolutely indicated. 2- In the indidivual whose unwell Xing is associated with a peaceful Jing Shen, the disease generally manifests at the muscles and bones. Therapeutically, the application of warm poultices (medications with calorific properties) and Qigong are advised. 3- In individuals whose peaceful Xing is associated with an unwell Jing Shen, the disease generally manifests at the flesh (dermis). Therapeutically, lithopuncture is indicated. 4- In individuals whose Wing and Jing Shen are simultaneously unwell, the disease generally manifests at the level of the laryngo-pharyngeal organs. Therapeutically, smoothing adoucissants/sweetened?√ medicines are recommended. 5- In individuals in states of frequent and repetitive fright, the circulation of the Jinmai (tendinomuscular channels) is blocked. The disease manifests by a loss of sensation (paresthesia, numbness). Therapeutically, massage with fermented (alcohol) medications are indicated. • _ _ _ _ _

Among disturbances of the 5 organs: the heart governs eructations the lung, cough the liver, logorrhea (2) the spleen, pyrosis (3) the kidney, yawning.

• _ _ _ _ _

Among disturbances of the 6 bowels: the gallbladder governs anger the stomach, the ascent of the energy (food) and hiccups the large and small intestines, diarrhea the bladder, urinary incontinence the Sanjaio, edema (anasarca).

• _ _ _ _ _ _

Among the 5 Sapors: the sour sapor first reaches the liver bitter, the heart spicy, the lung sweet, the spleen salty, the kidney tasteless/bland, the stomach.

2. Abnormal or pathologic garrulousness. 3. Heartburn, acid reflux.

• Among the 5 Gatherings: _ the gathering of the Jing (quintessence) within the liver causes melancholy _ the gathering of the Jing within the heart gives rise to laughter

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(unmotivated, incessant) _ the gathering of the Jing within the lung provokes affliction _ the gathering of the Jing within the kidney causes fright _ the gathering of the Jing within the spleen bringa about preoccupation. 439.

• _ _ _ _ _

Among the 5 Aversions: the liver fears wind the heart, heat the lung, cold the kidney, dryness the spleeb, humidity.

• _ _ _ _ _

Among the 5 Secretions: the heart governs sweat the liver, tears the lung, rhinorrhea (nasal mucus) the kidney, drool the spleen, sialorrhea (saliva).

• Among the 5 Fatigues: _ fatigue of the eyes affects the blood _ exaggeration of the/the lying-stretched out position taken to extremes harms the energy _ “ seated position injures the muscles _ “ standing position affects the bones _ “ walking harms the tendons. • Among the 5 Precipitations (Great Hastes): _ the sour sapor quickens se precipite the tendons _ the spicy sapor, the energy _ the bitter sapor, the blood _ the salty sapor, the bones _ the sweet sapor, the flesh. • _ _ _ _ _

Among the 5 Suppressions: the sour sapor is suppressed in ailments of the energy the bitter sapor is suppressed in ailments of the blood the salty sapor is suppresses in ailments of the bones the Yang disease, in winter the Yin disease, in summer.

• Among the 5 Perverse (Wu _ perverse energy infiltrating madnesses; agitated madnesses) _ perverse energy infiltrating blood) _ perverse energy infiltrating diseases like headache, vertigo...) _ perverse energy infiltrating _ perverse energy infiltrating leaving/exiting Yang, anger.

368

Xie, 5 Perverse Energies): into the Yang causes the Kuang disease (Yang into the Yin causes Xue Bi (obstruction of 440.

into the Yang causes Dian Xi (delerious into the Yin causes mutism (Yin) into Yang gives rise to calm, and Yin

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• _ _ _ _ _

Among the 5 Receivings: the heart receives the Shen (mental) the lung, the Po (sensitive soul) the spleen, the Yi (thought, reflection) the kidney, the Jing (quintessence) and Chi (will) the liver, the Hun (vegetative soul).

• _ _ _ _ _

Among the 5 Masters: the heart is master of the vessels the lung, master of the skin the liver, master of the tendons and muscles the spleen, master of the flesh (dermis) the kidney, master of the bones.

• _ _ _ _ _ _

Among the 3 Yin and 3 Yang: the Yangming has much blood and energy the Taiyang, much blood and not much energy the Shaoyang, much energy and not much blood the Taiyin, much blood and not much energy the Jueyin, much blood and not much energy the Shaoyin, much energy and not much blood.

This is why it is said: “During the needling of Yangming, one disperses the blood and energy. During the needling of Taiyang, one disperses the blood and not the energy. During the needling of Shaoyang, one disperses the energy and not the blood. During the needling of Taiyin, one disperses the blood and not the energy. During the needling of Jueyin, one disperses the blood and not the energy. During the needling of Shaoyin, one disperses the energy and not the blood. • The Foot Yangming (St) is in Biao-Li (external-internal) relationship with the Foot taiyin (Sp). The Foot Shaoyang (GB) is in Biao-Li (external-internal) relationship with the Foot Jueyin (Li). 441. The Foot Taiyang (Bl) is in Biao-Li (external-internal) relationship with the Foot Shaoyin (Ki). Such are the Yin-Yang, Biao-Li (external-internal) relationships of the channels of the foot. • The Hand Yangming (LI) is in Biao-Li (external-internal) relationship with the Hand Taiyin (Lu). • The Hand Shaoyang (SJ) is in Biao-Li (external-internal) relationship with the Hand Jueyin (XB). • The Hand Taiyang (SI) is in Biao-Li (external-internal) relationship with the Hand Shaoyin (He). Such are the Yin-Yang, channels of the hand.”

Biao-Li

(external-internal)

relationships

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of

the

EXPLANATIONS AND COMMENTARIES N.V.N.: 1- The heart governs eructation. According to our ancient masters, disturbances of the upper region of the stomach include those of the heart. Clinically, eructation is due to the flooding/afflux of the energy of the stomach hindering digestive metabolism√√. 2- Tasteless/bland sapor. It is not part of the group of “5 Sapors” because, before penetrating into the stomach, it is associated with Earth (spleen); it therefore is of the same type as the sweet sapor. 3- The “5 Gatherings” designate the 5 flowingsaffluences√ of the Jing (quintessence) of the organ toward another organ in a state of emptiness which triggers a specific pathology. In this way, for example, the flowing of the Jing of the other 4 organs toward the liver in a state of emptiness causes melancholy (sadness). In contrast, anger provoked by a blockage of the energy of Liver Yin or by a dysequilibrium between the energy of the liver and that of the gallbladder (liver in emptiness amd gallbladder in fullness). As a result, the process of triggering of these two pathologic phenomena is different and their treatment must be distinct. It is the same for the other flowings. 442.

insert figure

4- Each organs has an aversion: _ the liver fears wind because the wind contracts the muscles _ the heart fears heat because the heat injures blood vessels _ the lung fears cold because the cold impedes the circulation of the energy _ the kidney fears dryness because it likes coolness _ the spleen fears humidity because it likes dryness. 5- Regading the “5 Secretions”, Cao Shi Tong indicates: “The 5 organs absorb the dietary Jing and secretes it in the form of liquid at the level of the external orifices. Therefore, each organ has its own appropriate function of transformation and secretion of dietary Jing: tears, sweat, saliva, mucus and drool”.

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6- Regarding the “5 Fatigues”, Wan Xun mentions: “Prolonged staring is detrimental to the Shen (mental). This is why it can injure the blood. The prolonged lying position the energetic circulation. This is why it harms the energy. The spleen likes movement. This is why, _ the prolonged seated position harms the flesh, _ the prolonged standing position harms the lumbar vertebrae and bones, _ prolonged walking injures muscles and tendons”. 7- The “5 Sapors” are the Jing released during food metabolism. Before being directed to the corresponding organs, they first reach the spleen, the distributor organ of the dietary Jing.

insert figure

443.

8- In dietetics, the corresponding sapor of the ill organ must be suppressed or diminished. 9- Here, the term “5 Pathologic Manifestations” implies diseases of the 5 organs. In effect, _ the kidney is a Yin organ. It governs the osseous system and its diseases generally manifest at he level of the bony marrow; _ the heart is a Yang organ. It governs the blood and its diseases generally manifest at the level of the blood vessels; _ the spleen is a Yin organ. It governs the flesh (dermis) and its diseases generally manifest at the level of the dermal system; _ the liver is a Yang organ. It governs spring and Yang diseases of the liver start in winter; _ the kidney is a Yin organ. It responds to autumn and Yin diseases of the lung start in the summer.

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10- In past times, one utilized the term Dian Xi (delerious, wild diseases) to desugnate diseases of the cephalic region ( headache, vertigo...) caused by disturbances of the ascent and descent of the energy. Regarding this, we read in Chapter 80 (“Essay on the Orientation of the Energy Toward Excess and Insufficiency”) of the Suwen: Leigong: “Considering the excessive and insufficient states of the energy, which is favorable and which is unfavorable?” Huangdi: “Yang energy governs ascent and passes from left to right, and Yin energy governs descent and pssses from right to left. In the very old, their energy grows weaker first at the bottom; it originates then from the top; it descends. In young people, their energy is in fullness at the bottom; it originates then from the bottom; it ascends. In this manner, the energy of spring and that of summer responding to Yang are favorable and make life. In contrast, if they are oriented toward Yin as in autumn and winter, they are contrary and make death. It is the same for the energy of autumn and winter; when they respond to Yin, they are favorable and make life. This is why, independently of abundance and shortage, the contrary is always the cause of Jue disease (afflux/flooding).” Leigong: “Can energetic excess cause Jue disease?” Huangdi: “When the Yin energy has ascended and cannot descend, the two energies, Yin and Yang, lose their connection; from the feet to the knees becomes cold. Young people affected by this disease die in autumn, but the old can survive. When the Yang energy has ascended and cannot descend, the top is in fullness, and the bottom, in emptiness, provoking headache of the vertex whose Yin-Yang origin is difficult to determine because this ailment originates from the separation of the energies of the 5 organs. In this case, the clinical manifestations are not apparent, like a man living in a desert or shut up in an empty room, hence one sees nothing. The disease continues to worsen and generally survival does not exceed one day.” Zhang Zhongjing (150-210 A.D.) gives the following explanation: “ The energy belonging to Yang (man) and located to the left is favorable, and that belonging to Yin (woman) and located to the right is favorable. Because old people have less appetite; their energy occuring at the top is favorable. Young people often engage in lust; their energy occuring at the bottom is favorable. Spring and summer, the signs and pulses follow Yang; this is life. If they become directed toward Yin with Yin signs and pulses, this is death. Likewise, autumn and winter, the signs and pulses follow Yin; this is life. Therefore, whether the prientation of the energy is toward excess or toward insufficiency, the contrary is the single cause of the disease of afflux/ flooding (Jue).” From his point of view, Zhang Jing Yue (1563-1640 A.D.) continues:

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444.

“Spring and summer are the two periods of production of blood. The pulses and signs then are of Yang nature. If they reveal a Yin nature as during autumn and winter, they are contrary and fatal. In man, flooding (afflux) can be of Yin or Yang origin. When it is Yang, it is not inevitably due to a fullness of Yang. Likewise, when it is Yin, it is not necessarily caused by a fullness of Yin”.

11- The definitions of the words “Shen” (mental), “Hun” (vegetative soul), “Po” (sensitive soul). “Yi” (thought, reflection) and “Chi” (will) is clarified in Chapter 8 (“Origin of the Mental”) of this classic.

12- Each organ possesses Jing (quintessence) of different functions. In this manner, • _ _ _

The Jing of the heart has a triple function: anatomic function: blood vessels function of the “7 orifices”: speech (tongue) psychologic function: Shen (mental).

• _ _ _

The Jing of the lung has a triple function: anatomic function: epidermis function of the “7 orifices”: olfaction (nose) psychologic function: Po (sensitive soul).

• _ _ _

The Jing of the liver has a triple function: anatomic function: muscels and tendons function of the “7 orifices”: visual acuity (eyes) psychologic function: Hun (vegetative soul).

• _ _ _

The Jing of the spleen has a triple function: anatomic function: dermis function of the “7 orifices”: taste (lips) psychologic function: Yi (thought)

• _ _ _ _ _ _ _

The Jing of the kidney has seven functions: anatomic function: bones function of the “7 orifices”: hearing (ears) psychologic function: Chi (will) calorific function (organic heat) cooling function (organic cold) genetic function (heredity) sexual function (procreation).

445.

13- The excess and insufficiency of blood and energy are the two criteria that permit directing therapy toward tonification or dispersion during acupuncture. But in this paragraph, we find a slightly different explanation from that cited in Chapter 65 (“The 5 Musical Notes and 5 Sapors”) of the Lingshu and Chapter 24 (“Energy and Blood, Body and Mind”) of the Suwen.

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Nevertheless, the analysis of commentaries au fils of the centuries of our old masters show that the notions cited in the Suwen are correct.

We present below two tables: 1) A comparative table of three different chapters from classic works concerning excess and insufficiancy of blood and energy at the level of the 3 Yin and 3 Yang (Taiyang, Shaoyang, Ynagming, Taiyin, Jueyin, Shaoyin) for the purpose of research. 2) A table of classification of the properties and functions of of the 5 organs mentioned in this chapter.

446.

1 - Comparative table of the 12 channels

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6 Channels

Chapter 76, Lingshu

Chapter of Sing Shu

Chapter of Suwen

Taiyang (SI and Bl)

_ much blood _ little energy

_ much blood _ little energy

_ much blood _ little energy

Shaoyang (SJ and GB)

_ little blood _ much energy

_ little blood _ much energy

_ little blood _ much energy

Yangming (LI and St)

_ much blood _ little energy

_ much blood _ little energy

_ much blood _ little energy

Taiyin (Lu and Sp)

_ much blood _ little energy

_ much blood _ little energy

_ little blood _ much energy

Jueyin (XB and Li)

_ little blood _ much energy

_ much blood _ little energy

_ little blood _ much energy

Shaoyin (He and Ki)

_ much blood _ little energy

_ little blood _ much energy

_ much blood _ little energy

2 - Table of classification of properties/functions of the 5 organs

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5 Organs

Liver-Wood

Heart-Fire

Spleen-Earth

Energy of the 5 organs

logorrhea

eructation

regurgitation

cough

yawning

Energy of the 6 bowels

GB governs anger

Stomach governs hicups

LI governs diarrhea

Bl governs urinary incontinence

5 Sapors

sour

bitter

sweet

spicy

salty

5 Gatherings (of Jing)

malancholy

causeless laughter

preoccupation

affection

fright

5 Aversions

wind

heat

humidity

dryness

cold

5 Secretions

tears

sweat

saliva

mucus

drool

5 Fatigues

exaggerated walk: muscles & tendons

eye fatigue: blood

5 Precipitations

sour --> muscles & tendons

bitter --> blood

5 Suppressions

5 Receivings

5 Masters

suppress sour sapor

SI governs diarrhea

Lung-Metal

Kidney-Water

p rolonged seated exaggerated lying exaggerated position: flesh position: energy standing position: bones sweet --> flesh

spicy --> energy

salty --> bones

suppress bitter suppress sweet sapor sapor

suppress spicy sapor

suppress salty sapor Chi (will)

Hun (vegetative soul)

Shen (mental)

Yi (thought)

Po (sensitive soul)

Muscles & tendons

Vessels

Flesh

Skin

Bones

447.

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CHAPTER

LXXIX

Years and Dew (Zue Lo)

Chapter 79 of the Lingshu develops numerous ideas: _ the physiology and early and late causes of the periodic bouts and intermittent nature of the disease Nue (Fever/Chills); _ the “3 Emptinesses” and the “3 Fullnesses” in the determination of disease; _ perverse energy in a latent state and recent perverse energy; _ the methods of observation of wind (Feng) on the 1st day of the month of January (day of the lunar year) in the determination of prognosis of diseases during the 4 seasons. The explanation for the title of this chapter is given by Ma Shi: “In this chapter is found the phrase: “The simultaneous meeting of wind and rain bears the name “meeting of the year with dew”, hence the title, “Years and Dew” (Zue Lo).” This chapter contains 7 paragraphs.

PARAGRAPH 1 Huangdi questions Qi Bo: “According to the classics: “In summer, heat strikes us, and in autumn, the Nue disease (Cold-Heat: fever-chills) is triggered ( 1 ) . It manifests by periodic bouts of fever and chills”. What is its cause?” 448...

Qi Bo:

“At the level of Fengfu (GV 16), the perverse energy descends along the paravertebral muscles (Lu). At the end of each “day-night” cycle, the Wei ( d e f e n s i v e ) energy gathers at Fengfu (GV 16) , and the following days, it descends

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one verterba each day. This is why daily boiuts of fever and chills gradually become less frequent. Such is the relationship of cause to effect concerning the perverse energy during its attack at the level of the spinous muscles. This is why each day that the Wei energy arrives at Fengfu (GV 16), the sweat glands open up and the perverse energy profits to infiltrate into the interior and trigger bouts of fever and chills. As a result, the daily bouts are gradually slowed. As for the Wei (defensive) energy, upon its arrival at Fengfu (GV 16), it descends one vertebrae each day. By the 21st day, it arrives at the coccyx, and by the 22nd day, it penetrates inot the interior and follows the Fuchong ( 2 ) vessel to the top. By the 9th day, it emerges at the point located between the two Quepen (St 12; supraclavicular crease). Because the Wei energy progressively returns toward the top, the periods of bouts of fever and chills are gradually earlier. In contrast, if the perverse energy, via the routes of the Jingluo (principal and secondary channels) reaches the 5 organs which adjoin the peritoneum, the trajectory is long and the penetration deep; its circulatory movements are slowed down. As a result, in this case, the bouts of fever and chills cannot manifest daily, but only at the end of 2 days.”

EXPLANATIONS AND COMMENTARIES I - Ma Shi explains: “The content of this paragraph is similar to Paragraph 3 of Chapter 35 (“Discourse on the “Fever-Chills” Disease”). It is advised to consult it carefully.”

1. Here, it is does not involve “paludism” (malaria). This term translated by sinologists is not entirely exact because “paludism” is an infectious disease provoked by a specific hematozooan inoculated by the sting of a mosquito that is a member of the Anopheles species (Anopheles maculipennis). Here, it is instead a question of an energetic disease caused by a seasonal energy of the latent type. The Suwen states thusly: “In summer, perverse heat infiltrates into the organism and remains in a latent state until autumn to trigger the Nue disease (fever and chills), an intermittent disease.” 2. “Fuchong” is an internal vessel of the Chongmai (see Figure 1). 449....

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Figure 1: Circulatory path of perverse energy and Wei Qi (defensive energy) at the level of the Dumai (GV) and Chongmai.

II - N.V.N.: Some words used in this paragraph merit clarification. 1. According to the “Jia-I Jing” (? Boof of Changes?), the word “Lu” designates the 2 muscular rows located to the 2 sides of the spine where the Foot Taiyang (Bl) and the Luo vessels of the Dumai (GV) circulate. The translation “vertebral column” is not loyal to the text and deceives the practice of acupuncture. 449...

2. According to Zhang Jing Yue: “Fuchong is a branch of the curious channel Chongmai. Its name indicates that it is runs along the antero-interior surface of the spine. Once it has arrived at the coocyx, the Wei energy works its way into the interior to reach Fuchong which conducts it to the level of C7 - T 1 before diverting toward Tiantu (CV 22) (3),

point located at the superior border of the manubrium in a crease.” (Figure 1). 450.

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3. Chapter 2 (“Origin of the Shu (Antique) Points”) of this classic clarifies: “The point located between the 2 Quepen (St 12) belongs to the Renmai (CV). It bears the name Tiantu (CV 22).”

PARAGRAPH 2 Huangdi: “Each time the Wei Qi (defensive energy) arrives at Fengfu (GV 16), it causes the opening of the pores favoring the penetration of perverse energy to trigger disease. But the site of meeting of the Wei Qi and the perverse energy changes each day by one vertebrae. As a result, the periods of bouts of fever and chills do not coincide with the arrival of the Wei Qi at Fengfu (GV 16). How do you explain that?” Qi Bo:

“The 2 Fengfu (Palace of the Wind) do not have a very specific localization. The arrival of the Wei Qi at the location of the perverse energy is necessary to trigger the opening of the pores. This is why the zone of penetration of perverse energy is also that of the manifestation of the disease.” Huangdi: “Exactly! The disease of Wind (Feng) and that of Nue (Cold-Heat; FeverC h i l l s ) have a reciprocal relationship. But the fever caused by W i n d is continuous, while that of N u e is intermittent. Why?” Qi Bo:

“Once within the organism, Wind u s u a l l y remains at the fixed place while N u e follows the Jingluo (principal and secondary channels) to progressively pentrate to the organs. This is why, when the Wei energy arrives at the place of fixation of N u e , it creates a reactive phenomena that triggers the bouts of fever and chills.” 3. Whose specific actions are mentioned in “Medicine Traditionelle Chinoise”. N.V.N. edition.

Huangdi: “Absolutely!”

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains: “Wind (Feng) is the perverse Yang of Heaven. As a result, when it penetrates into the organism, it becomes fixed in the Yang (external) parts of the body. 451. Nue is a perverse energy belonging to the wind and cold, to heat and humidity. Its basic actions are to modify the state of Yin and Yang, the state of cold and heat of the organism. It follows the channels to carry out movement of entry and exit and wait for the Wei (defensive) energy to trigger bouts of fever and cills.”

II - N.V.N.: Here, the word “Fengfu” does not designate the point Fengfu (GV 16) of the Dumai (GV). In effect, there is not any site of penetration of perverse energy into the body having the name Fengfu; “Fu” means “place, spot” (palace) of penetration of perverse energy.

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In Chapter 35 (“Discourse on “Fever-Chills” Disease”), Paragraph 4, of the Suwen, Qi Bo states: “Perverse energy infiltrates into the cranio-cervical region, runs alongside the vertebral column and is directed toward the bottom; the signs of emptiness and fullness are not the same and the site of penetration of the perverse energy is different. This is why the bouts do not take place at the moment of the arrival of the Wei energy into Fengfu. Therefore, for example: _ when the perverse energy penetrates into the cranio-cervical region, the bouts appear upon the arrival of the Wei energy into this region; _ when the perverse energy penetrates into the dorso-lumbar region, the bouts appear upon the arrival of the Wei into this region; _ when the perverse energy penetrates into the region of the limbs, the bouts appear upon the arrival of the Wei into this region. In brief, the appearance of the bouts takes place at the time of passage of the Wei energy into the region affected by the perverse energy. Therefore, the site of infiltration of perverse energy is not constant. In this way, the response of the Wei energy to the perverse energy results in two key factors: opening of the pores and the site of induction of the perverse energy which is also the site of manifestation of the disease.”

PARAGRAPH 3 Huangdi questions Shao Yu: “ I have heard you say that the “8 Winds of the 4 Seasons” infiltrates into the organism to create two different energetic states, cold and heat. When it is involves cold, the skin and hair are taut, and the pores, very tightly closed; and when it involves heat, the skin and hair are lax, and the pores, greatly open. Must the perverse wind be associated with cold and heat or must it await the emptiness of the organism and the perverse energy of the “8 Climatic Periods of the 4 Seasons” ( 4 ) in order to trigger disease?” 452.

Shao

Yu: “Obviously not! The P i r a t e - W i n d does not attack man at fixed seasonal periods. But it acts at the time of opening of the pores when it takes advantage of the emotiness in order to deeply infiltrate into the interior. This is why, in this case, the evolutive process of the disease is extremely rapid. In contrast, when the pores are tightly closed, even if there is an attack of perverse energy, the disease is superficial ans slight and its evolution is relatively slow.”

EXPLANATIONS AND COMMENTARIES

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I - Zhang Shi explains: “The 4 Seasons have their Cold and their Heat in alternation. Among the “8 Winds”, one distiguishes Cold-Wind and Heat-Wind. During the infiltration of Wind Cold into the organism, the skin and hair are tense and the pores closed and during the infiltration of Heat-Wind, the skin and hair are flaccid, and the pores, open. As for “Pirate-Wind”, it infiltrates only into organism if the energy of the body is in a state of emptiness and not due to the opening/closure of the pores provoked by the cold and heat.”

II - N.V.N.: This paragraph speaks about the infiltration of wind into the organism. In this regard, Zhang Jing Yue clarifies: “The perverse wind can penetrate into the organism without waiting for the “8 Climatic Periods of the 4 Seasons” during which the perverse energy takes advantage of the energy of the body to create the disease. The pernicious energies of the “8 Climatic Periods of the 4 Seasons” are called ““Pirate-Wind” - Perverse Energy”. This paragraph clearly distiguishes the orientation and location of Tai Yi (Great Principle of the 1st Celestial Stem) (5) already mentioned in previous chapters of this classic.

4. See Chapter 26 (“Incidence of the 8 Principal Rhythms on Human Energy”) of the Suwen, Volume II, N.V.N. Edition. We have translated it as “4 Seasons - 8 Astronomic Rhythms”. 5. Principle based on macrocosmic phenomena consisting of determining the favorable or unfavorable state of Wind coming from the 8 direcions of the cosmos (8 cardinal points) with the purpose of predicting the quality of rice harvest. This principle is still more commonly used by Oriental agriculturists than Western ones.

Obviously, the opening of the pores favors the penetration of perverse energy and the disease is deep, hence the seriousness and rapid evolution of the disease. But, the perverse energy also can infiltrate into the organism when the pores are closed. In that case, the disease is superficial, hence the benignness and slow evolutioon of the disease.” 453.

PARAGRAPH 4 Huangdi: “Even in some individuals well-adapted to the cold and heat and endowed with a properly closed sweat gland system, disease can suddenly occur. What is the cause of this?” Shao

Yu: “ D i d √n’a-t-elle pas eu His Majesty not have knowledge of the cause of attack of perverse energy?” In individuals leading a normal life, the opening and closing of the pores and the contraction and relaxation of the skin are not linked to climatic variation, causal factor of the triggering of disease.” Huangdi: “Could you explain it to me in detail?” Shao

Yu: “Man exists in relationship to Heaven and Earth and rsponds to the sun and moon. This is why,

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_ at the full moon, the water of the sea is abundant to the West...; in man, the blood and energy are plethoric, the flesh and muscles are firm, the hair is long and firm and the skin is covered with a substance (sebum). Upon encountering the Pirate-Wind (perverse energy), it becomes localized superficially, at the exterior, without being able to penetrate deeply to the interior; _ when the moon is waning, the water of the seas is abundant to the East...; the blood and energy are in insufficiency and the Wei (defensive) energy disperses; the bodily form assumes its usual appearance, but the flesh and muscles are weaker, the skin is lax and the pores are open; the body hair and head hair dry out and the cutaneous folds are sparse; the substance is dilute. In this period, the Pirate-Wind can infiltrate deeply into the interior to trigger fatal disease.”

EXPLANATIONS AND COMMENTARIES 454.

N.V.N.: 1. In this paragraph, Shao Yu bases his judgment on the Yin nature of the West (Occidental) and the Yang nature of the East (Oriental) to explain the high seas and low seas caused by the movements of lunar and solar attraction according to very specific periods (full moon and waning moon) (Figure 2).

Figure 2:

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Phenomena of lunar attraction.

Yang Shang Tian clarifies: “The sun is Yang. The moon is Yin. The sea of the West (Occidental: Atlantic Ocean) is Yin. The sea of the East (Oriental: Pacific Ocean) is Yang. The moon has its full and empty phases. The human body and the water of the seas follow the rhythm od emptiness and fullness of the moon. The moon is Yin responding to water. This is why, at the full moon, the sea of the West (Atlantic Ocean) is plethoric, and at the waning moon, the sea of the East (Pacific Ocean) is plethoric. Such are the phenomena due to an insufficiency of Yin and excess of Yang.” 455.

2. Regarding the cutaneous folds, here is the explanation of Zhang Shi: “The cutaneous folds are the sites of gahering of small vessels (capillaries) coming from the Sanjiao (SJ). This is why they have the name Jiao Li (paths of Jiao: “heater”, “Jiao”).”

PARAGRAPH 5

Huangdi: “Some individuals affected by severe diseases die suddenly, and others serious diseases which manifest loudly. Why?” Shao

Yu: “In individuals affected by the “3 Emptinesses” (San Xu) , the disease is fatal and death occurs suddenly. In contrast, in individuals affected by the “3 Fullnesses”(San Shi), the perverse energy cannot attack them.” Huangdi: “I would like you to tell me about the “3

Emptinesses.”

Shao

Yu: “The annual energy in a state of insufficiency (Xu Nian), the moon in a waning period (6) and the climatic energy (of the 4 seasons) in disequilibrium from Pirate-Wind (perverse energy) within the organism are the “3 Emptinesses”. As a result, the physician who ignores the “3 Emptinesses” is a poor practitioner.” Huangdi: “And the “3

Fullnesses” ? ”

Shao

Yu: “The excess of annual energy (Nian Shi), the full moon and the balanced climatic energy are the “3 Fullnesses” (San Shi) which do not permit the PirateWind to penetrate into the human body.” Huangdi: “Your explanation is excellent! I desire that this be dranw up in the “Coffer of Gold” under the name San Shi (3 Fullnesses). Naturally, it concerns here an irrefutable reasoning coming from the impulse of the heart√ √ . ”

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EXPLANATIONS AND COMMENTARIES

456.

I - Zhang Shi explains: “The “insufficiency of the annual energy (Xu Nian)” designates the deficiencies of the 6 energies belonging to Si Tian: Tiquan (7). The “climatic energy in disequilibrium” explains the abnormal state of the energy of the 4 seasons. The Wei Qi (defensive energy) is constantly in relationship with Heaven and Earth, with the sun and moon. As a result, upon the simultaneous encounter of the year whose energy is in insufficiency (Xu Nian) from the moon in a waning period and disequilibrated climatic energy, the Wei energy becomes unstable. 6. First and last quarter of the moon. 7. See definition in Chapter 73 (“Study on the Origin of Disease”) in the Suwen, Volume III, N.V.N. Edition.

The Wei Qi has the function of protecting and consolidating the external part of the body. When it is in a state of emptiness, the pore open up and allow the perverse energy to penetrate brutally into the organism, directly to the organs to trigger sudden death.”

II - N.V.N.: This paragraph stresses the basic notions of diagnosis and treatment of energetic Oriental medicine: “3 Emptinesses and 3 Fullnesses”.

PARAGRAPH 6 Huangdi: “I would like to know how in some years many people are affected by the same illness?” Shao

Yu: “This originates from the energetic state of the “4 Seasons, 8 Energetic Divisions” (Si Shi Ba Cheng) (8). ” Huangdi: “How

is

this

energy

observed?”

Shao

Yu: “One usually observes this climatic energy on the Dong Zhi day (winter solstice), the period during which Tai Yi (Great One: Supreme Unity) is displaced to the He Xi (Palace of Hibernation) and causes reactive phenomena of Heaven, that is to say, from wind and rain. 457.

If this wind and rain comes from the South, they are harmful and bear the name Xu Feng (Vicious Wind). If they occur in the middle of night when people are asleep, they cannot attack them. This is why, in that year cette annee-la, sick individuals are relatively few in number. In contrast, if they come in the middle of the day, poorly- protected people are eaisly prone to attack by Xu Feng ; this is why in that year ill individuals are very numerous.

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But Xu Feng, during its attack, infiltrates up to the bone and remains in a latent state until Li Chun (Beginning of Spring), the period of growth of Yang and the opening of the pores. If, in this period, the wind comes from the West, people are attacked again by Xu Feng. The 2 perverse energies, Xu Feng and latent perverse energy, battle between themselves and provoke a change in the energy at the level of the Jingluo, hence disease.

8. See Chapter 26 (“Incidence of the 8 Principal Rhythms on Human Energy”) of the Suwen, Volume II, N.V.N. Edition. We have translated it as “4 Seasons - 8 Astronomic Rhythms”. (see Footnote 4).

Therefore, the simultaneous meeting of wind and rain have the name “Meeting of the Year with the Dew”. If the energy of the year is harmonious, there is little Pirate-Wind; ill individuals are not very numerous and mortality is minute. In contrast, if the energy of the year is in discordance, they is much PirateWind; ill individuals are numerous and mortality is higher.”

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains: “1. The “8 Energetic Divisions” (Ba Cheng) are: _ Dong Zhi (winter solstice) _ Xia Zhi (summer solstice) _ Chun Fen (spring equinox) _ Qiu Fen (autumn equinox) _ Li Chun (beginning of spring) _ Li Xia (beginning of summer) _ Li Qiu (beginning of autumn) _ Li Dong (beginning of winter).

458.

Clearly determine the position of the “8 energetic divisions” to observe the arrival of the wind and rain. In this way, for example: _ on the Dong Zhi (winter solstice) day, the wind comes from the South; _ on the Li Chun (beginning of spring) day, the wind comes from the West... . These noxious winds are harmful to health. In effect: _ on Dong Zhi (winter solstice), at the Zi hour (23h-1h), the energy of the body begins to arsie/be born√. This is why the perverse wind is able to penetrate deeply to the bones and remain there ina latent state; _ on Li Chun (beginning of spring), the Yang energy of the body increasesnd the pores open up favoring a new penetration of wind coming from the West. These winds fuse with the latent perverse energy and block the circulation of the Jingluo, hence disease. 2. Wind is the energy of Heaven, and rain is “dew” (Lo) which also comes from Heaven. This is why windy and rainy years bear the name “Years and Dew” (Zue Lo). The year during which the wind and rain arrive conforming to the previous date of the season is

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harmonious; noxious wind is rare; the people are joyous and individuals rarely are ill. In contrast, if the wind and rain are contrary to the season, the year is unstable; patients are numerous ane mortality rises.”

II - N.V.N.: 1. In relation to the latent perverse energy, our explanation is the following: Perverse energies can penetrate at a specific moment into the organism and remain there in a latent state waiting for the favorable time to manifest, as indicated in the Suwen (Chapter 5“Phenomena of Correspondences of Yin and Yang”): “In winter, perverse Cold infiltrates into the organism and remains in a latent state until spring to trigger the disease of heat. In spring, perverse Wind infiltrates into the organism and remains in a latent state until summer to trigger diarrhea. In summer, perverse Heat infiltrates into the organism and remains in a latent state until autumn to trigger the disease of Cold-Heat (fever-chills). In autumn, perverse Humidity infiltrates into the organism and remains in a latent state until winter to trigger cough”. These assertions clarify the duration of incubation of perverse energies and their periods of manifestation. In the majority of cases, this incubation is rendered possible by poor bodily and a diminished capacity of defense of the organism, hence weakness localized to certain regions favoring the infiltration of perverse energy. 459.

The ancient classics say in this regard: “The site of emptiness is the site of infiltration of perverse energy.” For example: a. In winter, some individuals, during marked sweating (from excessive practice of physical activities), display an opening of their pores; perverse cold easily infiltrates by this sweat gland route, free to insert itself into the epidermodermal tissue fibers. b. In individuals displaying a weakness of the energy of the kidney, perverse cold penetrates into the organism and resides in the Shaoyin (Ki) channel. In a general way, diseases of latent perverse energy manifest in spring and summer. During these periods of birth/growth of Yang, latent perverse energy is activated by a new infiltration of perverse energy and triggers disease. But, sometimes, latent heat of summer only declares itself during the meeting of the “cool” energy of autumn; sometimes, the latent perverse energy can manifest via its own movements. In clinical practice, the key point is to base one’s judgment on the duration and seriousness of the symptoms in order to distinguish “latent perverse energy” from “recent perverse energy”. If the signs of recent perverse energy are followed by signs of chronic disease, it is recent perverse energy which has activated the latent perverse energy. In contrast, if at the starting phase, in the absence of signs of latent perverse energy, the disease manifests by serious signs like very high fever evolving toward the syndrome “Fire-Dryness of the Yin Root”, this is the sign of auto-manifestation of latent perverse energy.

2. In one year there are 2 types of “dew” (Lo). According to Yang Shang Zian: “Spring-like dew” (Chun Lo)controls the reproduction of the “thousand beings”, and “autumnal dew” (Qiu Lo) governs the destruction of the “thousand things”. Example: the year, in autumn, dominated by noxious wind and rebellious rain weakens beings and things, is “Zue Lo” (rainy and windy dew or “year of dew”).”

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PARAGRAPH 7 Huangdi: “Noxious wind causes benign or serious diseases. How do you distiguish and prognosticate them?” Shao

Yu: “On the 1st day of the month (lunar) of January, Tai Yi (Grand One) is located at Tian Lu (Palace of Celestial Circulation). If the wind oocurs from the Northwest on this day, without rain, mortality is raised. If, at dawn of the 1st day of the month of January, the wind occurs from the North, in spring of that year many individuals are affected by serious diseases that can lead to death. 460. If, at dawn of the 1st day of the month of January, the wind occurs from the North, the increased number of patients is estimated at 3 out of 10. If, at noon of the 1st day of the month of January, the wind occurs from the North, the summer of that year, mortality is elevated. If, at the close of the 1st day of the month of January, the wind occurs from the North, the autumn of that year, morality is elevated. If, during the entire day of the 1st day of the month of January, the wind occurs from the North, numerous are the individuals affected by serious disease with an estimated mortailty of 6 out of 10. • If, on the 1st day of the month of January, the wind occurs from the South bearing the name Han Xiang (indicator of dryness) and the wind of the West bearing the name Bai Gu (white bone) , all the country is in misfortnem a l h e u r ; the mortality is elevated. If, on the 1st day of the month of January, the wind occurs from the East, houses are strongly secured, and sand and gravel, stirred up; all the country is in great disaster. If, on the 1st day of the month of January, the wind occurs from the Southeast, in spring of that year, mortality is elevated. If, on the 1st day of the month of January, the climate is mild and without wind, the harvest is abundant and the price of rice is low; the people are in good health. In contrast, if this day, the weather is cold and windy, the harvest is poor and the price of rice is expensive; many people are ill.

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Such are the manifestations of wind in a year permitting prediction of the arrival of the perverse energy, factor of disease in man. • On the Chou (2nd Terrestrial Branch) day of the 2nd month (lunar), if the wind is absent, the people are affected by numerous diseases of the heart and abdomen. On the Xu (11th Terrestrial Branch) day of the 2nd month, if the weather is not mild, the people are affected by numerous diseases of Cold-Heat. On the Si (6th terrestrail Branch) day of the 4th month, if the weather is not warm, the people are affected by numerous diseases of Dan Re (icterus). On the Shen (9th Terrestrial Branch) day of the 10th month, if the weather is not cold, the people are affected by numerous severe and sudden diseases. The different types of wind cited above, shaking houses, breaking trees, carrying away sand and gravel, ruffling body and head hair, causing opening of the pores, are part of the group called “Abnormal Perverse Wind” . ”

EXPLANATIONS AND COMMENTARIES

461.

I - Zhang Shi explains:

“During the 2nd, 3rd and 4th months, the Yang energy is plethoric. As a result, if the wind is absent on the Chou (2nd TB) day, if mild heat (Wen) is absent on the Xu (11th TB) day and if the weather is not warm on the Si (6th TB) day, this originates from the voctory of the Yin energy preventing the development of the Yang energy. Therefore, the people are affected by many diseases. The 10th month is the period during which the Yin energy is in fullness. As a result, cold is absent on the Shen (9th TB) day because the Yang energy is victorious preventing the conservation of the Yin energy. This is why the people are affected by diseases leading rapidly to death.”

II - N.V.N.: This paragraph concerns the study of prediction of diseases during the 4 Seasons according to the direction of the wind. This observation, since antiquity, has been and still is transmitted by tradition. The “Chinese Book of Astronomy” notes: “The Yuan Dan day (1st day of the lunar year) dominates the “8 Winds”.” In our time, clearly understood, one cannot be satisfied with this observation based only on climatic change of the 1st month of January (lunar) to predict the seriousness or benigness of diseases during the entire year.

no 462/463.

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CHAPTER

LXXX

The Great Problems/Confusions√ (Dai Hua)

Chapter 80 of the Lingshu speaks on: _ the vertiginous states to high places en hauteur _ and certain pathologic phenomena such as: forgetfulness, bulimia, anorexia, insomnia, somnolence, clinomania (1). • The Jing Qi (energetic quintessence) of the human being is concentrated at the eyes and has a close relationship with the brain. As a result, the sudden appearance of an object can disseminate the Shen (mental) and Hun (vegetative soul) and disturb the cerebral Jing and ocular Jing, hence vertigo. • Amnesia originates on the one hand from the fullness of the gastrointestinal system and the emptiness of the cardiopulmonary system, and on the other hand, from the insuficiency of the energy of the top (of the body) and the excess of the energy of the bottom (of the body). • Bulimia is due to a too active heat of the stomach which the metabolism of the Shui Gu (water-cereals). • Anorexia results from the obstruction of the energy at the level of the stomach (bowel. • Insomnia comes from the temporary stoppage of the Wei (defensive) energy within the Yang zone without ability to reach the Yin zone. • Somnolence is the opposite of insomnia, that is to say, it is due to the stoppage of the Wei energy within th Yin zone without ability to reach the Yang zone. • Clinomania (desire to stay in bed) is due to a relatively significant amassing, piling up of gastrointestinal energy which causes: _ a transitory slowing down of the circulation of Qi (Ying and Wei) at the level of the epidermo-dermal system, _ a temporary stoppage of the Wei energy at the level of the organs 464. _ and a transient cessation of all activities (mental and physical). As a result, the individual has an exagggerated tendency to watch overgarder the bed (to sleep). • These “small problems”, very common in clinic, are usually caused by “confusion” embarass in the diagnosis and treatment. This is why this chapter has for a title: “The Great Confusions” (Dai Hua). This chapter contains 9 paragraphs.

PARAGRAPH 1

Huangdi: “I have often climbed toward Dai Sheng Liang (observation post constructed

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at an elevated, cool or cold peak of a mountain). On my way, I turned my head to observe the 4 sides, then would continue to ascend... I had the feeling that my Shen (mental) and Hun (vegetative soul) were grasped by panic and my gaze to be found in a state of fascination. First, I begin to examine the core/depthf o n d of myself, closing and opening my eyes, then I tried, but in vain, to tranquilize my “heart” (Xin) and calm my “energy’ (Qi) . Arriving at the summit, I looked again at the 4 sides and the same vertiginous phenomenon seized me. My bun attached, I placed myself on my knee, head bent downward to look. Gyrating motions continued, then suddenly disappeared. What is the energy responsible for these vertigoes and these dizzy spells?” Qi Bo:

“The Jing Qi (energetic quintessence) of the 5 organs and 6 bowels reaches the top to flow down/empty√ into the eyes. • • • • • •

The deep cavity containing the Jing is named “ e y e ” . Osseous Jing forms the p u p i l (Dong Si). Tendinous Jing, the i r i s . Blood Jing, the Xue Luo (blood capillaries). Energetic Jing, the sclera (Ba Yan). Dermal Jing, the eyelids (Yu Shu).ˆ

In this manner, the Jing Qi of the muscles, bones, blood and energy, associated with the Luo, form the ocular system. 465. • Above, the Jing Qi reaches the brain, and to the rear, it comes out at the nucha. This is why, when the perverse energy affects the neck and nucha at a time of emptiness of the energy of the body, it infiltrates deeply into the brain via the ocular route to cause Nao Chuan (cerebral whirling) followed by ocular tensions characterized by dizzy spells and turning movements” (vertigo). • When perverse energy attacks the ocular Jing, this Jing becomes exhausted and loses its harmony with the 5 organs and 6 bowels. The exhaustion of the ocular Jing causes disturbances of vision marked by the perception of two images for only one (diploplia). In conclusion, the eye is: _ the site of perception of the Jing _ the site of permanent passage of (defensive energy), the Hun (vegetative _ and the site of production of the

of the 5 organs and 6 bowels the Ying (nutritive energy) and the Wei soul) and the Po (sensitive soul) Shen Qi (mental energy).

This is why, when the Shen Qi is overtaxed, overworked, the H u n and P o become dispersed and the Chi (will) and Yi (thought) a r e disturbed. • The pupil and iris are ruled by Yin (liver and kidney); the sclera and blood vessels, by Yang (lung and heart). When Yin and Yang unite to form the eyes, the

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ocular Jing is luminous and bears the name Jing Ming (Luminous, Radiant l u m i n e u x Jing). • The eyes are the “ambassadors” of the heart, and the heart is the dwelling place of the Shen (mental). When the Jing and Shen are disturbed, the heart can no longer transport the Jing toward the eyes. • The perception of abnormal images is due to the dissemination of the Jing and Shen, Hun and Po. In other words, the isolation of these energetic components is the cause of dizzy spells and vertigo.”

EXPLANATINS AND COMMENTARIES N.V.N.: This paragraph concerns the pathophysiology of the eye. The “deep cavity” designates the ocular orifice, site of flowing out of Jing Qi (energetic quintessence) of the 5 organs. All 5 colors also reach this site. 467. In effect, in Chapter 17 (“Subtleties of the Pulse Examination”) of the Suwen, we read: “The “Jingming” (ocular) (1) energy appears at the eyes. It originates at the 5 organs and permits the observation of beings and things, the distinguishing of black and white, the knowledge of dimensions. In contrast, to take long for short, white for black, is the sign of exhaustion of the Jing of the 5 organs.” 1- Wu Guan clarifies: “The “Jingming” (ocular) energy appears at the eyes, and the colors, at the face. Jingming and the colors are traits of luminous manifestation of the pure energy (Jing) of the 5 organs.” 2- Zhang Jing Yue states: “a- The kidney governs the osseous Jing. It responds to Water and its color is jet black. This is why the interior of the pupil (Dong Si) is excessively gleaming, but the color reflecting at the exterior is black. b- The liver governs the tendinous Jing. It responds to Wood and its color is green. This is why the color of the iris (He Yan) is more pale than that of the pupil. c- The heart governs the Jing of the blood vessels. it responds to Fire and its color is red. As a result, the ocular vessels (Luo) are controlled by the Xin-Shen (heart-mental). d- the lung governs the energetic Jing (quintessence). it responds to Metal and its color is white. As a result, the sclera (Ba Yan) is formed from the Jing of the lung. e- the spleen governs the dermal Jing and responds to Earth. In ophthalmology, the eyelids are formed by the Jing of the spleen and bear the name Yu Shu (movements of opening and closing; covering and protection of the anterior part of the eye). 1. “Jingming” is also the name of the point Bl 1.

f- “...perverse energy affects the neck and nucha”. In other words, during infiltration of perverse energy into the points Fengfu (GV 16), Tianzhu (Bl 10)..., it penetrates deeply into the brain via the ophthalmic route to cause ocular tension, hence ablouissements and vertigo. 3- Ma Shi notes: “In ophthalmology, Yin designates the liver and kidney; and Yang, the lung and heart. As a result, to speak of Yin and Yang in a state of harmony reaching the eyes is to speak of the energy of Jingming (ocular Jing). All of these mental and cultural activities have their source at the heart. But the heart uses the eyes in order to manifest... . This is why the eyes are the “ambassadors” of the heart and the heart is the dwelling place of the Shen.” 466.

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Figure 1: The different energetic zones of the eye.

Figure 2: The Jing of the 5 organs and the ocular system (according to Zhang Jing Yue). 468.

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Figure 3:

Jingming (luminous Jing of the eye).

PARAGRAPH 2 Huangdi: “I have doubt about the truth of your account because each time I returned to Dong Yuan (post constructed at the Garden of the East) , I have always experienced vertigo. But this vertigo disappears immediately upon leaving this place. Will my Shen (mental) and my Hun (vegetative soul) always be unsteady chancelants each time I will ascend to the Garden of the East? Why does so bizarre a phenomena exist?” Qi Bo:

“No! The heart has its desires, and the S h e n , its repulsions. These desires and its repulsions, furing their encounter, disturb the Jing ( q u i n t e s s e n c e ) and prevent the eyes from seeing distinctly which brings the S h e n to a confusing situation, hence dizzy spells. As soon as one leaves the place, the S h e n returns and tthe state normalizes. Therfore, the situation cited is described according to 2 degrees of seriousness: _ the slight state of confusion called M i _ and the serious confusion called H u o . ” EXPLANATIONS AND COMMENTARIES

469.

Ma Shi notes: “When the Shen has an aversion against anything, the Chi (will) does not follow... . When aversion and sympathy join, the Jing Qi (energetic quintessence) is disturbed and the Shen leaves its place, then it returns.”

PARAGRAPH 3

Huangdi: “Some individuals suffer from a m n e s i a . What is the energy responsible for this illness?” Qi Bo:

“ A m n e s i a originates from the insufficiancy of the energy at the top and excess of energy down below. This means to say that the intestines and stomach are in fullness and that the heart and lung are in emptiness. Th heart and lung being in emptiness, the Wei (defensive) energy remains below. In the end, the reascent of this energy at the is no longer assured, hence amnesia” ,

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EXPLANATIONS AND COMMENTARIES I - Zhang Jing Yue gives us this information: “The phrase “...excess of energy down below” is used to contrast the bottom from the top. It does not at all indicate the excess energy of the bottom.

Insert figure

470.

In effect, the heart and lung being in emptiness at the upper part of the body, the Ying (nutritive energy) and Wei (defensive energy) stagnate at the bottom. The Shen Qi (mental energy) cannot reach the entire body, hence forgetfulness. It is a question of the syndrome of insufficiency of Yang of the upper part of the body.”

PARAGRAPH 4

Huangdi: “Some individuals often are hungry, but they refuse to eat. What is the energy responsible for this?” Qi Bo:

“The Dietary Jing gathers at the spleen and the Yang-Heat energy is retained within the stomach. The Yang-Heat energy retained within the stomach activates digestion. This is why the individual gets hungry quickly. If the energy of the stomach floods/affluxes towrds the top, therefore in a contrary direction, it obstructs the stomach canal, hence a n o r e x i a . ”

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EXPLANATIONS AND COMMENTARIES N.V.N.: According to energetic medicine, anorexia is due to an obstruction of the stomach canal (esophagus), causing obstruction provoked by a contrary afflux/flooding (Jue Ni) of the energy of the stomach.

insert figure

PARAGRAPH 5

471.

Huangdi: “Some individuals suffer from i n s o m n i a . What is the energy responsible for that?” Qi Bo:

“The Wei (defensive) energy, not suceeding in reaching the Yin part, remains within the Yang part. The Yang energy is then found in a state of fullness and the fullness of this Yang energy causes that of the Yangqiao. In this manner, the penetration of the Wei energy within the Yin part is not assured; the Yin energy is found in a state of emptiness. This is why the eyes can no longer open, hence i n s o m n i a . ”

EXPLANATIONS AND COMMENTARIES

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I - Zhang Shi explains: “The Yinqiao and Yangqiao unite at the point Jingming (Bl 1) of the Taiyang (Bl). The Wei (defensive) energy circulates within the Yin and Yang parts (of the body). All energies carry out movements of entering and exiting at the level of the point Jingming (Bl 1).

insert figure

This is why The Nejing defines the eyes as sites of reunion of Ying (nutritive energy) and Wei (defensive energy), Hun (vegetative soul) and Po (sensitive soul). 472. II - N.V.N.: This paragraph involves the energetic pathophysiology of insomnia, uniquely dependent of the circulatory state of of the Wei energy within the Yin part or Yang part of the body. According to Zhang Jing Yue: “The Wei energy circulates during the day woithin the Yang part, and during the night, within the Yin part. When it is found at the Yang, the individual awakes, and when it is found within at the Yin, the individual goes to sleep. In contrast, in the ill individual, sleep and waking are disordered. Usually, the Wei energy remains longer in the Yin or in the Yang, hence disequilibrium of “Yin-Yang”, responsible for disordering of sleep and waking.”

PARAGRAPH 6 Huangdi: “Some individuals, due to disease, close their eyes and can no longer see. What is the causal energy?”

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Qi Bo:

“The Wei (defensive) energy retined within the Yin part does not come to the Yang part. The Wei energy being retained within the Yin part, the Yin energy is found in a state of fullness. This fullness causes that of the Yinqiao. Therefore, when the penetrattion of the Wei energy within the Yang part is not assured, the Yang energy is found in a state of emptiness. This is why the eyes close; the individual can never see and is found in a state of s o m n o l e n c e . ” reach

EXPLANATIONS AND COMMENTARIES N.V.N.: This paragraph and the previous one have a relationship with the two channels, Yinqiao and Yangqiao. The closing and opening of the eyes has been studied in Chpater 21 (“Diseases of Colc and Heat”) of this classic: “...at the level of the region of the Yangqiao and Yinqiao where the Yang energy enters into the Yin and the Yin energy exits the Yang. When the Yang energy becomes directed toward excess, it provokes opening of the eyes (insomnia), and when the Yin energy becomes directed toward excess, it brings about closure of the eyes (hypersomnia). 473.

Zhang Shi states: “The entry of the energy of the Yangqiao and the exiting of the energy of the Yinqiao via the route of the Yangqiao is carried out at the level of the point Jingming (Bl 1), located at the internal canthus of the eye. When the Yang energy is in excess at this level, it causes opening of the eyes (insomnia) and when the Yin energy is in excess, it provokes closure of the eyes (hypersomnia).”

PARAGRAPH 7 Huangdi: ”Some individuals have an exaggerated tendency to watch over the bed (clinomania) in order to find sleep. What is the causal energy?” Qi Bo:

“In these individuals, _ the stomach and intestines are of large size _ the skin is damp _ and the zone of distribution of the flesh (Fan Rou: interdermo-muscular s p a c e ) is coarse. Due to the large volume of the stomach and intestines, the time of retention of the Wei (defensive) energy is relatively long. Due to the humidity of the skin and coarseness of the “zone of distribution of the flesh”, the circulation of the Wei energy is relatively slow. • Normally, the Wei energy circulates, during the day, within the Yang part, and during the night, within the Yin part. When this circulation within the Yang part approaches its end, man must sleep; and when this circulation within Yin part approaches its eend, man must wake. • At the level of the stomach and intestines of large size, the Wei energy must

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stop for a longer time. At the level of the humid skin and coarse “zone of the distribution of the flesh” (Fan Rou), the circulation of the Wei energy must slow down. • When the Wei energy remains for a longer time within the Yin part, its circulation is no longer normal; this is why man tends to close his eyes to look for sleep. • In individuals whose stomach and intestines are os small size, the skin is smooth and taut, the “zone of distribution of the flesh” is finer and free and the Wei energy remains for a longer time withn=in the Yang part. This is why they sleep very little.”

EXPLANATIONS AND COMMENTARIES 474.

N.V.N.: Zhang Jing Yue adds information on post-prandial somnolence: “After a meal, the longing to sleep is due to an accumulation of “cold” (food) energy within the stomach and intestines. The Wei (defensive) energy is then found in a state of fullness in the Yin part, hence desire to sleep. Some are ignorant of this mechanism and mistake it for a weakness/fatigue of the spleen (Pi Quan).”

PARAGRAPH 8 Huangdi: “Some indivuals with regularly poor sleep suddenly have need of a great sleep. What is the energy responsible for this?” Qi Bo:

“The perverse energy is retained within the Shangjiao (Upper Jiao- UJ). It is obstructed and its energy can no longer reach the Yang part, hence sudden need for sleep. The sudden need for sleep is also due to too abundant an absorption of cold water after a full meal. In this case, the Wei energy is retained within the Yin part, hence desire to sleep.”

EXPLANATIONS AND COMMENTARIES N.V.N.: In this paragraph, Qi Bo has furnished the causes of a audden need for sleep. Recall that, in clinic, one often encounters patients suffering from insomnia. This ailment is doe to the presence of perverse energy localized in the organism preventing the We energy from reaching the Yin part.

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Huangdi: “Perfect! How do you treat them?”

475.

Qi Bo:

“It is necessary: _ first, to reestablish the function of the 5 rgans and 6 bowels, _ then, to eliminate the different types of benign perverse energy _ and finally, to utilize dispersion in the event of fullness (of perverse energy) and tonification in the event of emptiness (of the energy of the body). But before treating, it is necessary to carefully examine the state of the Chi (will) and Xing (bodily form) of the individual.”

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains: “The ailments cited in this chapter are benign, but confused during diagnosis and treatment. a- “...to reestablish the functions of the 5 organs and 6 bowels” implies the sense of harmonization of the Jing (quintessence), Qi (Ying and Wei energies), Shen (mental) and Sanjiao (SJ), essential components of energetic physiology. b- “...to eliminate the different types of perverse energy” means to say to suppress the benign and confusing signs that cause serious complications. c- The word “Chi” (will) is often employed in the global sense to designate psychologic components like Jing (quintessence), Shen (mental energy), Hun (vegetative soul), Po (sensitive soul), Yi (thought) and Chi (will). d- The state of the Xing (bodily form) depends on that of the Jing (energetic quintessence), Ying (nutritive energy), Wei (defensive energy), Xue (blood) and Qi (energy). This is why: _ the Chi (will) in a disturbed state injures the Shen (mental) _ and the Xing (bodily form) overtaxed damages the Jing (quintessence)."

II - N.V.N.: In summery, to attenuate or cure a disease or morbid manifestation by acupuncture, one must: _ know not only the points and channels _ but also and especially the "energetic approaches" )Jing, Qi, Shen, Sanjiao). 476.

Zhang Jing Yue adds: "Suffering (excessive sadness) carries detriment to the Yang zone belonging to the Lung-Heart, and excessive joy injures the Yin zone belonging to the Spleen-Kidney. One must thinks of this during treatment."

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477.

CHAPTER

LXXXI

Abscesses and Tumors (Yung Ju)

This last chapter of the Lingshu (Chapter 81) speaks on the causes of the formation of abscesses (Yung) and tumors (Ju). The evolutive phases and fatal periods of these ailments are indicated and earlytreatment is absolutely advised. Localization of the different forms of abscesses and tumors are also presented. this is why this chapter is entitled: "Abscesses and Tumors" (Jung Ju). It contains 20 paragraphs.

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PARAGRAPH 1 Huangdi: "I know from hearsay that: _ the stomach and intestines receive the Ge Qi (cereal energy) _ the Shangjiao (Upper Jiao- UJ) releases Qi (energy) to heat up the flesh parts, maintain the joints ans aerate the sweat gland system (Cou Li) _ the Zhongjiao (Middle Jiao- MJ) releases Qi (energy) which, comparable to dew, spreads within the Xi Gu (valleys and small valleys), flows down within the Sunluo (blood-energetic capillaries) and harmonize the Xin Ye (organic liquids) which become transformed into Xue (blood); _ in the harmonious state, the blood fills first the Sunluo, then the Luomai (secondary vessels) and finally, the Jingmai (principal channels); 478.

_ in the plethoric state, Yin and Yang circulate under the propulsive action of the respiratory movements and perform cyuclic transmissions around the body conforming to the cyclic movements of the natural world (Heaven-Earth); _ one must examine the pulses and apply the method of regulation. In the event of fullness, one must add the emptiness; this is to utilize the method of dispersion to reduce the fullness; _ the rapid removal of the needle diminishes the virulence of the perverse energy and the the needle left in place augments the potential of the essential energy of the body. Therefore, to treat the insufficiency is to tonify the emptiness to gain back the excess. I know where the equilibrium and disequilibrium of blood and energy come from, but I still do not know how Yung (abscesses) and tumors (Ju) are produced and their periods benigness and seriousness, life and death. I would like you to inform me about all this." Qi Bo:

"The circulation of the Jingmai is perpetual conforming to the stellar movements of Heaven and periodic movements of Earth. When the stellar movements are irregular, they cause: _ the eclipse of the sun or moon _ the overflowing of the river routes _ the drying out of plants and trees _ the poor harvest of the Wu Gu (5 Cereals) _ the division of the routes of communication _ and the isolation of people in the hamlet. The same phenomena take place at the level of the blood and energy. Please the reasons. The Xue (blood) and Mai (vesssels), Ying (nutritive energy) and Wei (defensive energy) circulate with stopping. At Heaven, they respond to the astral movements, and at Earth, to the flowing of rivers. hear

When the cold perverse infiltrates into the Jingluo (principal and secondary channels), it provokes a blood stasis which calls on the Wei energy. This concentrates around the blood stasis with the inability to carry out movements of

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return, hence the formation of Yung

(abscesses).

The "cold" energy in a state of compression becomes transformed into heat ( 1 ) . This toxic heat decomposes the organic tissues and transforms them into pus. Non-evacuated pus softens the muscles and tendons. In a state of softening, they damage the bones, and when the bones are damaged, the marrow becomes exhausted. 479.

Pus is localized within the bony cavities. If the pus is not eliminated, the blood dries out, the muscles and bones are no longer maintained and the flesh (dermis) is no longer saturated; the infected Jingmai are "smoke out"e n f u m e n t the 5 organs. When the 5 organs are affected, it is death."

1. It is a question of "false heat".

EXPLANATIONS AND COMMENTARIES I - Ma Shi explains: "The rapid removal of the needle evacuates the perverse energy in a state of fullness, the the needle left in place augments the potential of the energy of the body in a state of emptiness."

II - N.V.N.: 1- This paragraph speaks on the process of pyogenic formation, explanatory basis of the external pathology of Oriental energetic medicine. One distinguishes 3 principal phases of the process: a- Inflammatory Phase _ infiltration of cold within the interchannel spaces _ slowing down of blood circulation _ stasis formation with disturbances of Xue (blood) and Xin Ye (organic liquids) _ influence on the Ying (nutritive energy) and Wei (defensive energy) _ concentration and accumulation of Wei with absence of return circulation, hence tumefaction and inflammation. b- Pyogenic Phase _ transformation of cold into heat ("false heat", toxic heat) _ domination of heat and destruction of organic tissues wwith pyogenic formation. c- Malignant Phase _ non-evacuation of pus and pyogenic fixation within the neuromuscular system _ degradation of the musculoskeletal system _ infestation of the Jingluo system _ overheating and "smoking out" of the 5 organs (death).

2- The energy released at the level of the Shangjiao (UJ) designates the Wei Qi (defensive energy) which has for functions: heating up the flesh parts, maintaining the joints and aerating the sweat gland system. The energy released at the level of the Zhongjiao (MJ) is the Ying Qi (nutritive energy). It is comparable to the dew which humdifies plants because it explains the mechanism of secretion of the Xin Ye (organic liquids) which maintain the entire body. 480. • Xi Gu designates the small valleys and valleys. Chapter 37 ("Study on the Affluxes/ Flooding of the Energy") of the Suwen indicates: "The great reunion of the flesh is called "Gu" and the little reunions, "Xi". the interflesh spaces are the sites of reunion of the Xi and Gu, sites of circulation of Ying Qi and Wei Qi and sites of

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reunion of the Da Qi (great energy)." • Here, Yin and Yang are the generic encompassing Blood and Energy, Organs and Bowels, Jing and Luo, Interior (Li) and Exterior (Biao) of the body. In man, the energy and blood are activated by the respiratory rhythms and function accroding to a very specific law: "With each expiration, the energy advances 3 cun, and with each inspiration, the energy advances 3 cun, that is, 6 cun for every respiration."

3- We present below a schematic study of the different phases of pyogenic formation (Figure 1).

Figure 1: Pyogenic formation and degradation of the musculoskeletal system with attack of the 5 organs.

PARAGRAPH 2 Huangdi: "Please explain to me in detail the different forms of Yung

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(abscesses) and Ju

( t u m o r s ) and their fatal periods as well as their names." 481.

Qi Bo:

"At the subaxillary region (lower) and below the laryngo-pharyngeal organs, the ailment bears the name Meng Ju (powerful tumor). Without treatment, it transforms into pus whose non-elimination causes an obstruction of the throat (gullet). Death occurs in a half day. During the evacuation of pus, prescribe a diet composed of chilled Shi Gao (melted pork fat). Cure occurs in 3 days."

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains: "The throat is the "door" of respiration. the respiratory movements at this level are very powerful. This is why the abscess located at this part of the neck is called Meng Ju (powerful tumor). When pus is formed, one must eliminate it urgently to avoid an obstruction of the throat which can cause death in a half day.

Figure 2: Formation of Meng Ju (abscess of the throat). 482.

Pork is an animal which responds to Water. Its melted and cooled fat (lard) has the property of conveying

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the toxic heat toward the bottom to be eliminated via the recto-vesicular route."

II - N.V.N.: Because of its location, Meng Ju (powerful tumor) is also called "abscess of the throat". It is due to an accumulation of toxic heat at the level of the 3 channels: Renmai (CV), Foot Jueyin (Li) and Hand Taiyin (Lu) (Figure 2).

PARAGRAPH 3 "At the neck, The affliction is the name of Yao Ju (fatal tumor). This voluminous tumor becomes red black. If it is not urgently treated, the toxic heat descends within the axillary crease. First, it reaches the anterior part of the thorax and injures the Renmai (CV), then it penetrates deeply and "inflammes" the lung and liver. Death occurs in 10 days."

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains: "The neck is the site of passage of blood and energy of the Shaoyang and Yangming (SJ/GB and LI/St). The abscess located within this region of the neck must be treated without delay in order to block the descent of the heat into the axillary crease. Three cun below that, the point Yuanye (GB 22, on the anterior axillary line in the 4th intercostla space) is found from where a vessel arises which oenetrates deeply into the thorax and reaches the Renmai (CV) on the one hand, and on the other hand, the lung and liver. Toxic heat follows this route and contaminates these two organs; death occurs in 10 days. According to the Neijing, "The good physician first treats the Bi Fu (epidermo-dermal system), then the Jingluo (principal and secondary channels) and, finally, the Zangfu (organs/bowels). The physician who treats abscesses and tumors must follow this rule."

II - N.V.N.: According to Zhang Jing Yue (1563-1640 A.D.), Yao Ju (fatal tumor) is an asbcess located behind and below the ear, 1 cun 3 fen from there. This cervical tumor is rarely curable. That of the right belongs to LiverWood, and that to the left, to Lung-Metal. Zhang Shi's thesis can be diagramed in the following fashion (Figure 3). 483.

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Figure 3: Formation of Yao Ju (cervical tumor) and its fatal evolution.

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PARAGRAPH 4 "The Yang Qi (Yang energy) in great fullness overheats the cranium and accumulates at the nucha to trigger Nao Que (nuchal tumor) . The individual is anxious and pains are of the needle-stick type. When the disease reaches the interior, it causes "agitation" of the heart. The disease is incurable; it ends up generally in death." EXPLANATIONS AND COMMENTARIES

484....

I - Zhang Shi explains: "Yang Qi "in great fullness" designates the energy of the 3 Yang (Taiyang, Shaoyang, Yangming) affected simultaneously. Here, the 3 Yang are represented by the Taiyang (2). It possesses a vessel which enetrates deeply into the brain and comes back out at the neck and nucha. When the Yang energy is in great fullness, it overheats the brain and accumulates at the nucha to trigger Nao Ju (nuchal tumor). • The heart is the Taiyang in Yang. The heart and Taiyang (SI) unite at the level of their root (Jiao) and their summit (Ben). When the energy of the heart is compressed, the inidivual is sad and has palpitations. It concerns phenomena of interference of toxic heat of the bowels at the level of the organs. These phenomena are fatal." II - N.V.N.: According to Zhang Jing Yue, Nao Ju (nuchal tumor) is due to a blockage of Yin Jing (Yin quintessence) with exhalation of the toxic heat toward the top. Nao Ju manifests at the point Fengfu (GV 16). At the starting phase, it is small like a mustard seed of grey-violet color. Then it enlarges and takes the form of a big twig. In serious cases, it can reach the top of the skull or descend to the point Dazhui (GV 14). Pain is totally absent; moxabustion must be applied until pain appears. Tianjin gives the following definition: "The word "Nao Que" implies the sense of "fire" which melts metal. The inflammation is located at the nucha. Toxic heat there is in maximal fullness. At any moment, it can reach the cranium or descend to Dazhui (GV 14). The cranial vault is overheated, hence the name "Nao Que" (Figure 4)."

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2. The Taiyang opens to the exterior and plays the role of protection of the entire system of Jingmai (principal channels of the body). 485...

Figure 4: Formation of Nao Que (nuchal tumor) and points of the Foot Taiyang (Bl) (vessels amanating toward the interior of the cranium).

PARAGRAPH 5

484...

"At the shoulder and arm, the affliction is called Pi Yung (inflammatory s t a i n t a c h e ) ( 3 ) . It is of blackish red color. Urgent treatment consists of provoking a hypersweating to the feet. This disease does not reach the 5 organs. If it goes back 4 or 5 days, moxabustion is absolutely advised."

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EXPLANATIONS AND COMMENTARIES Zhang Shi explains: "Pi Yung also has the name Jianyu Yung (shoulder abscess). This abscess is superficial. it does not injure the 5 organs. Moxabustion is used to eliminate the perverse energy by the calorific route."

3. Also see "Pi Yung of the knee", page 493∆.

PARAGRAPH 6 " Mei Ju (sheathed or ganglionic tumor) is red and firm. It manifests at the axillary crease. treatment consists of performing several sticks at the level of the tumor with the aid of a fine and long needle of stone (lithopuncture). After needling, smear the points of impact with pork fat. Cure will be obtained at the end of 6 hours. Bandaging Mei Ju is advised against. If the tumor remains hard without suppuration, it is a question of Ma Dao Jia Yung (scrofula) . One must treat it urgently."

EXPLANATIONS AND COMMENTARIES

486.

I - Zhang Shi explains: "The needle of stone must be fine in order not to injure the tissue system and long to perform deep sticks. The sticks must be awayeloignee from one another. II - N.V.N.: According to the basic explanation of external pathology of Classical Chinese Medicine, Mei Ju manifests in the form of a granule in the middle of the axillary crease (axillary adenitis). It is due to the solidification of the sanguino-energetic stagnation during compression of the energy of the Foot Jueyin (Li) and Foot taiyin (Sp) (Figure 5).

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Figure 5: Formation of Mai Ju (axillary tumor). As for Ma Dao Jia Yung (scrofula), it is due to disturbances of the energy of the 3 channels: Hand Shaoyang (SJ), Foot Jueyin (Li) and Foot Shaoyang (GB). It has an elongated and hard form (like stone). Sometines, it starts in the subauricular region and reaches the supraclavicular area or scapular region to descend to the hypochondrial region. In serious cases, it occurs at the front of the thorax and creates red and inflammed projections with pyogenic formation. Upon encountering the wind, the pus becomes liquified and exudes without stopping. its prognosis is grave.

PARAGRAPH 7

487.

"Jing Ju (tumor in a well en puits) manifests at the thorax and presents in the form of a bean. Without treatment, at the end of 3 or 4 days, it reaches the abdomen and becomes iincurable. Death occurs iin 7 days." EXPLANATIONS AND COMMENTARIES N.V.N.: The word "Jing" (well, shaft) implies the sense of depth. According to Zhang Jing Yue, Jing Ju manifests right in the cadiac fossa (thorax). At the start, it has the form of a yeloow bean without ant change in the skin. It also bears the name Chuan Xin Du (penetrating tumor crossing the heart). This disease is extremely serious.

PARAGRAPH 8 "Gan Ju (sweet tumor) breaks out in the thoracic region. It has a greenish color and the form of a fruit of Trichosanthis (Qualou) ( 4 ) . Generally, the individual is sometimes feverish, sometimes chilled. Urgent treatment consists if combatting the fever and chills (Han Re). The affliction can last 10 days, then death occurs. On the day of death, the suppuration begins to flow out." EXPLANATIONS AND COMMENTARIES I - Ma Shi explains: "The tumor is located at the top and slightly to the side of the breast, at the point Yingchuang (St 16), in the 3rd intercostal space, belonging to the Foot Yangming (St) which responds to Earth and the sweet sapor. This is why on gives it the name "sweet tumor of the breast".

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This affliction originates from the energetic stasis following a chronic psychoaffective illness (anguish, anxiety...)." 4. Spicy plant (family Curcubitacea) from Asiatic tropical regions and yielding a long and tortuous fruit.

II - Zhang Shi adds: "The thorax belongs to the Jueyin (Li) and Yangming (St). The Yangming (St) activates the movements of transformation of the Taiyin (Sp), and Jueyin (Li) stimulates the movements of metamorphosis of the Shaoyang (GB). These movements of exchange of Yin and Yang are responsible for the alternating 488. movements of cold and heat. This affliction is due to the compression of toxic energy of the liver organ and stomach bowel. It "summit" (Jiao) is found at the level of the Luomai (secondary vessels) and its "root" (Ben), at the level of the diaphragm. This is why it is difficult to make it disappear. It becomes very active when the energy of the body becomes weakened."

Figure 6: Formation of Gan Ju (breast tumor).

PARAGRAPH 9 " Bai Ju (rigid tumor) manifests in the hypochondrial region. This disease generally is encountered in women. It is recommended to treat it with moxabustion. When pus is formed, an excrescence of flesh the size of a red bean appears at the center of the tumor. it is advised to prescribe a decoction of leaves of the root of Lingqiao (Forsythia) . Boil 1 sheng of leaves and 1 sheng of root of this ingredient in 1 dou 6 sheng of water until reduced to 3 sheng. Have the patient drink this decoction, dress him warmly and settle him close

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by the boiler until sweating reaches the feet. Cure is therefore assured." EXPLANATIONS AND COMMENTARIES

489.

I - Zhang Shi explains: "The hypochordria, subaxillary area, belongs to the lung and liver. This type of tumor settles in the epidermo-dermal layer, hence the name Bai Ju (fixed tumor). In women, the energy is usually in excess, and the blood, in insufficiency. This disharmony of blood and energy often causes this ailment. This is why the text states that "this diseases is usually encountered in women". When the tumor is in the pyogenic phase, treatment is moxabustion, the method applied to large abscesses. Although the afliction bears the name "BaiJu" (fixed tumor), the mortification of the flesh and muscles and softening of the bones are absent. Leaves and roots of Lingqiao (Forsythia) are utilized because: _ the leaves have the property of purifying heat and provoking sweating _ the roots have the property of releasing toxicity." II - N.V.N.: Acording to Zhang Jing Yue, Baiju (fixed tumor) also has the name Xia Ju (hypochondrial tumor). The hypochondria is the region belnging to the liver. In women, anger and rage are the principal causes of this disease (Figure 7).

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PARAGRAPH 10

Figure 7: Formation of Bai Ju (fixed tumor). 490.]

" Gu Xing Ju (tumor of femur and tibia) manifests at the thigh and leg. Its external appearance does not present itself with clearly notable changes√ . But in the interior, pus eats away and softens the bones. Without treatment, death occurs in 30 days."

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains: "Tumor of the thigh and leg is due to the presence of perverse energy of great virulence of the Foot Shaoyin (Ki). This toxic energy adheres to the bones, inflamming them, without exteriorizing. Wothout treatment, death occurs in 30 days. The kidney is a water organ, and the moon respond to Yin and to Water, Such is the reason for death occuring in 30 days."

II - N.V.N.: According to Zhang Jing Yue, Gu Xing Ju designates osteitis of the femur and tibia.

Figure 8:

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Formation and location of Gu Xing Ju (osteitis of the femur and tibia).

PARAGRAPH 11

491.

" Rui Ju (piercing p e r c a n t t u m o r ) manifests within the coccygeal region. it is red in color, large and firm. Without urgent treatment, death occurs also in 30 days."

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains: "The coccyx is part of the Foot taiyang (Bl). The kidney and bladder are respectively water organ and water bowel. The kidney responds to Yin and governs the bones. This is why the tumor adheres to the bones. The bladder is Yang and governs the Yang (external) part of the body. As a result, the tumor is hard, large and red. Despite the overflowing of toxic Yang toward the exterior, death occurs in 30 days because the Taiyang is "master" of all Yang channels. Yin and Yang, Zang (organs) and Fu (bowels), Jing (quintessence) and Shen (mental), Xue (blood) and Xin Ye (organic liquids), Jiao (summit) and Root (Ben), Biao (exterior) and Li (interior) are indispensible notions for the practice of medicine, notions which permit physicians to do research on "species of life among species of death√". Also, specialists who treat abscesses and tumors even moreso must delve deeply into all these notions developed in the Neijing."

II - N.V.N.: According to Zhang Jing Yue, Rui Ju originates from the concentration of toxic energy coming from the Foot Shaoyin (Ki) and Foot Taiyang (Bl) (Figure 9).

Figure 9:

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PARAGRAPH 12

Formation of Rui Ju (tumor of the coccyx). 492.

" Chi Shi (red p a r t i c i p a n t ) manifests within Gu Yin (internal part of the thigh). Without treatment, death occurs in 60 days. The bilateral affliction is incurable and the individual dies in 10 days."

EXPLANATIONS AND COMMENTARIES I - Zhang Shu explains: "Gu Yin (internal part of the thigh) belonging to the 3 Yin channels, Foot Shaoyin (Ki), Foot Jueyin (Li) and Foot Taiyin (Sp). Toxic fire develops to amaximum there, hence the name Chi Shi (red participant). Sixty days is the number of realization (formation) of water, and 10 days, the last of the Yin numbers." II - N.V.N.: Due to its location, Chi Shi also carries the name Gu Yin Ju (tumor of the inner thigh). The inner thigh is the area where the points _ Jimen (Sp 11) and Xuehai (Sp 10) of the Foot Taiyin (Sp) and _ Yinbao (Li 9) and Wuli (Li 10) of the Foot Jueyin (Li) are found.

Figure 10: Formation of Chi Shi (tumor of the inner thigh).

493.

This is also the area of passage of the Foot Shaoyin (Ki). In summary, the entire thigh is the site of reunion-meeting of the Yin Qi (Yin energy). As a result, the absence of treatment is equivalent to death. When the affliction reaches the the two thighs, the Yin is fatally affected bringing on death.

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PARAGRAPH 13 " Pi Yung (inflammatory staint a c h e ) (5) manifests at the knee. It has the appearance of learge swelling that is hard as stone. The skin is not changed, but this affliction is accompanied by a syndrome of Cold-Heat (fever and chills). At the starting phase, lithipuncture is prohibited because erroneous use of stone points to eliminate pus indicates death. It is advised to await the pyogenic phase to aplly lithopuncture in order to assure the life of the patient."

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains: "The knee is the site of reunion of the tendond and muscles making up part of the Foot Shaoyang (GB). Pi Yung is due to the fixation of toxic energy within the half-internal and half-extenrla space of the energetic layer controlled by the Shaoyang (SJ/GB). It is considered the "hinge of the door" and the toxic energy follows the movements of the Shaoyang; sometimes it reaches the Taiyang (Cold-Water), someimes it descends toward the Yangming (Dryness-Heat) to trigger the alternating phenomena of cold (chills) and heat (fever). It is advised against to use lithopuncture because, at the starting phase, the toxic energy follows the path of the Shaoyang to penetrate into the interior (Yangming) and aggravate the disease. One must then wait for the tumor to become much softer (pyogenic phase) to needle to evacuate the pus via the route of the Taiyang (Figures 11 and 12)."

Figure 11: Movements of the Shaoyang. 494.

II - N.V.N.: According to Zhang Jing Yue, Pi Yung is due to the fullness of the energy and emptiness of blood. The tumor of soft quality has a good prognosis, and that of hard quality, a very poor prognosis. The bilaterality of the disease indicates its incurability and is associated with the group of paraplegic diseases. 5. See also "Pi Yung of the arm", page 424.

PARAGRAPH 14 "Abscesses

417

(Yung) and tumors

(Ju) localizing at vertebral articulations, to the

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left or right and at the top or bottom, are all incurable. Those which manifest in the Yang region herald death in 100 days, and those which arise in the Yin region herald death in 30 days."

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains: "The word "articulation" used in this paragraph refers to the 21 articulations of the vertebral column (cervical, thoracic and lumbar). 495. Each articulation constitutes the site of exchange of the energy (Jiao Qi) and the site of entry and exit of the Shen Qi (mental energy) responding to the 5 organs. Therfore, _ the 3rd articulation (C3 - C 4) responds to the lung organ

_ the 4th articulation (C4 - C 5) responds to the Xin Bao Luo (XB) _ the 5th articulation (C5 - C 6) rsponds to the heart organ _ the 7th articulation (C7 - T1) responds to the liver organ _ the 11th articulation (T4 - T5) responds to the spleen organ _ the 14th articualtion (T7 - T8) responds to the kidney organ. • To speak of the number "100 days" is to designate in general the number of the sun (day) and to speak of the number "30 Days" is to designate in general the number of the moon (month) (6). According to Yu Ba Rong: "The abscess localizing at vertebral articulations with radiation to the two sides injures the Back Shu of the organs and bowels. In contrast, if the abscess manifests at the midline of the back, that is to say, at the Dumai (GV) which is linked to the organs, it is death."

II - N.V.N.: According to Zhang Jing Yue, the vertebral articulations are sites of passage of entering and exiting of the Shen Qi. As a result, one must not allow them to become infected by toxic energy. 496.

The disease becomes serious and incurable when it is localized above with radiation toward the bottom, to the right with radiation to the left and vice versa. When the lesion manifests within the Yang region, the disease is superficial and is associated with the bowel; death occurs in 100 days. When the lesion occurs in the Yin region, the disease is deep and is associated with the organ; death takes place n 30 days.

6. See explanation in Volume II, Chapter 40 ("Yin and Yang - Pure and Impure") of the Lingshu, J.T.S. Edition.

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Figure 13: Formation and location of vertebral tumors (according to Zhang Shi).

PARAGRAPH 15 "Tumor localizing at the leg has the name Tu Nia (bite m o r s u r e of the rabbit) . It is red to the bone. One must treat urgently because it places the life of the patient in danger."

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains: "The rabbit is an animal responding to Yin. As a result, the tumor localizing in the Yin part of the leg bears the name Tu Nia (rabbit bite). This ailment is due to the infiltration of toxic energy at the level of the descending branch of the Chongmai, at the inner surface of the leg, causing a blood obstruction which swells up like a rabbit snout√ ?museau . " II - N.V.N.: According to Zhang Jing Yue, at the ulcerous phase of Tu Nia (osteitis of the tibia), one notes an outflowing of pus mixed with viscous substance.

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Figure 14: Formation of Tu Nia (tibial osteitis) and the descending branch of the Chongmai.

PARAGRAPH 16

497...

"Tumor localizing at the internal malleolus bears the name Zou Huan (slow pace ' a l l u r e ) . It has the appearance of an abscess (Yung), but the color of the skin remains unchanged. Lithopuncture is utilized. One must needle the inflammed and edematous site. This treatment is aimed at combatting the syndrome of Cold-Heat. This tumor is not fatal."

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains: "This paragraph speaks on the localization of perverse energy at the level of the region of the Foot Shaoyin (Ki) responsible for edematous abscess (Yung Shung). Among abscesses (Yung) and tumors (Ju), there exist two types which are of external origin, the perverse energy going from exterior to interior, and there exist two which are of internal origin, the perverse energy going from interior to exterior. Here, the perverse energy comes from the Foot Shaoyin (Ki) and stagnates within the vessels to trigger Zou Huan. its appearance is that of an abscess (Yung), but the color of the skin remains unchanged. 498...

The Foot Shaoyin (Ki) starts below the little toe, reaches the middle of the sole of the foot, ascends to Rangu (Ki 2), arrives at the internal malleolus... . It receives the a priori Qi Shui (water energy). Therefore, its disturbances always manifest via Cold (chills) and heat (fever)." II - N.V.N.: Due to its location, Zou Huan also has the name Nei Que Ju (tumor of the internal malleolus). 497....

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Figure 15: Formation of Zou Huan (tumor of the internal malleolus).

PARAGRAPH 17 (4

498...

"The tumor localizing at the dorsal surface and sole of the foot is named Si Zin Disturbances) . Its shape is that of a big abscess. One must treat it urgently; otherwise death occurs in 100 days."

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains: "Here, the words "Si Zin" (4 Disturbances) implies the sense of disturbances of the left and right region of the 2 channels Tai and Shao: _ The Shaoyang governs the energy of birth (Sheng Qi) of primary Yang emitted by the kidney; _ The Taiyang is at the same time bowel of the kidney and "master" of the energy of the Yang channels. As a result, it is necessary to urgently treat this ailment, otherwise the Yang energy will be damaged and death will take place in "3 moons" (3 months)." II - N.V.N.: According to Zhang Jing Yue, the Yang receives the energy at the level of the 4 limbs. When a large abscess occurs at the foot, toxic Yang is in great fullness (superimposition of Yang) with emptiness of the Yin root. This becomes exhausted even more over time; this is why the text states that death occurs in 100 days. 499.

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Figure 16: Formation of Si Zin (tumor of the dorsal surface and sole of the foot).

PARAGRAPH 18 "The abscess located at the side of the foot bears (formidable r e d o u t a b l e a b s c e s s ) . It is not of great size. At little toe One must urgently treat it to eliminate the black progressively gets bigger and the disease worsens and takes place in 100 days."

the name Li Yung the start, it is as big as a blood, otherwise the abscess becomes incurable. Death

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains: "Here, cold perverse occurs at the point Lidui (St 45) and the abscess appearing at this level is called Li Yung (formidable abscess). Black is the color of water and cold, the energy of Heaven. If one does not eliminate the black blood, cold increases its potential and injures Earth (Stomach-Spleen: Yangimg-Taiyin)." II - N.V.N.: According to Zhang Jing Yue, at the starting phase, Li Yung has the size of a small toe, puffed up and long. This is the indicator of the presence of perverse energy within the Jingluo. When the Wei Qi (defensive energy) converges at this spot the abscess becomes rounded and emerges. The explanation of Zhang Shi is not clear because here it is a question of an abscess located to the side of the sole of the foot and not the second toe. 500. When he uses the word "Li" from Lidui (St 45), it is probably because the toxic energy infiltrates first into the Foot Yangming (St) before reaching the side of the sole of the foot.

PARAGRAPH 19

"The abscess localizing at the toe is named Tou Yung (escaping abscess) . It is blackish red in color. The disease is incurable and the prognosis is grave. If the ailment does not regress, one must urgently cut the ganrenous digit to avoid death."

EXPLANATIONS AND COMMENTARIES

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I - Zhang Shi explains: "Here, the toxic energy occurs at the Foot Shaoyin (Ki), then it escapes from the iinterior toward the exterior, that is to say, from Yin toward Yang to trigger the abscess called Tou Yung (escaping abscess). The Foot Shaoyin (Ki) recieves the a priori energy: Water and Fire. The black red color of the abscess indicates the excessive fullness of toxic fire and toxic water. The prognosis is fatal. In contrast, if the color becomes neither red nor black, it is sign of regression of the perverse energy; the prognosis os favorable. If the color remians black-violet, it is the indicator of acceleration of the virulence of the toxic energy. Surgical intervention is urgently indicated to save the patient; otherwise the perverse energy proceeds to converge toward the 5 organs, and death is inevitable."

II - N.V.N.: According to Zhang Jing Yue, tou Yung also bears the name Tou Ju (escaping tumor). In the majority of cases, this tmor is located on the hand or foot. At the start, it is the size of a rice grain and presents in the form of a small vesicle that contains yellow serum. First, it is red like the color of a very ripe jujube, then it priogressively becomes black. First, it localizes at the toe, then it speards to the others and to the foot itself. The pain is of the burning type. the morbid process is characterized by change in the tissues and their putrification. Urgent surgery must be strictly performed. Zhang Jing Yue recalls the importance of the points of this region: "The Yuan, Shu,... points are founhd on the foot. This is why the abscess of tis region are very harmful. 501.

It is the same for the Jing points located at the tips of the toes. SAt this level, red black color indicates worsening of the disease. Only surgical intervention can save the patient."

PARAGRAPH 20 Huangdi: "You have spoken about abscess (Yung) and tumors (Ju). But how do you differeniate them?" Qi Bo:

"Ying (nutritive energy) and Wei (defensive energy) blocked within the interchannel spaces prevents blood from circulating, hence blood stasis whose presence impedes the circulation of Wei energy. This concentrates and overheats, hence fever. The heat which predominates is responsible for the mortification of the tissues and suppuration.

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This ailment does not progress deeply. The marrow and bones are intact; the 5 organs are not damaged. this is why one names it Yung (inflammation, abscess) . Huangdi: "Good. What about Ju (tumor) ? ' Qi Bo:

"In the state of compression, the heat in maximal fullness penetrates deeply within the skin and muscles and provokes a drying out of the marrow and bones exhausting the Xue (blood) and Qi (energy). At the deep zone, it decomposes the muscles and bones. Such is the process of the formation of Ju (tumor) . The skin covering the J u is hard and dark gray like that of the neck of a buffalo, whereas that covering Y u n g is thin and shiny. Such is the distinction between Ju (tumor) and Yung (abscess) . "

EXPLANATIONS AND COMMENTARIES I - Zhang Shi explains: "This paragraph establishes the difference between an abscess (Yung) and tumor (Ju) as a function of the cyclic and perpetual movements of the blood and energy able to be modified according to the degree of virulence of the toxic energy on the one hand, and on the other hand, as a function of the "ungrateful" or generous" heart of the individual, that is to say, of the terrain.

In human beings, the blood and energy carry out the same cyclic and perpetual movements as that of Heaven and Earth. The least disordering of these movements causes abscesses and tumors. 502.

• It is because of that the sage has created the "9 Needles" associated with the Santai (3 Principles: Heaven-Man-Earth) to restore the work of the Creator. These several thousand words inscribed on bamboo tablets must be transmaiited to future generations in order to avoid disastrous results. The raising of the moral standards√of the Creator is therefore immense."

II - N.V.N.: To facilitate research work, we present below a synthetic table of the types of abscesses and tumors cited in this last chapter of the Lingshu.

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Localization and name

Symptomatology

Treatment

_ lard _ evacuation of pus _ cure in 3 days

Prognosis

1- Meng Ju (Throat abscess)

_ pyogenic formation

_ non-evacuated pus = throat obstruction _ death in a half day

2- Yao Ju (neck tumor)

_ large tumor _ dark black red color

Without urgent treatment: _ descent of toxic heat into the axillary crease _ disturbed Renmai (CV) _ overheating Li/Lu _death in 10 days

3- Nao Que (nuchal tumor)

_ anomaly of color and Shen _ needle stick type of pain

_ incurable disease _ fatal prognosis

4- Pi Yung (shoulder and arm abscess)

_ black red color

_ moxabustion

_ urgent treatment with sudorification _benign prognosis (5 organ level undisturbed)

5- Mei Ju (subaxillary tumor)

_ red and hard

_ long needle _ lard application _ no dressing

_ cure in 6 days

6- Jing Ju (intrathoracic tumor)

_ bean sized, hard, without ulceration

_ urgent treatment

_ progression to abdomen _ death in 7 days

503.

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Localization and Name

Symptomatology

Treatment

Prognosis

7- Gan Ju (thoracic/breast tumuo)

_ size of Trichsanthis fruit _ fever and chills

_ urgent treatment _ combat intermittent fever

_ death in 10 days _ pyogenic outflow on day of death

8- Bai Ju (hypochondrial tumor; disease of women)

_ large abscess with excrescence of flesh _ bean sized

_ moxabustion _ decoction of Forsythia _ treatment by fumagation

_ benign prognosis

9- Gu Xing Ju (thigh and leg tumor)

_ no change at level of skin _ in interior, pus adheres to the bone

10- Rui Ju (coccyx tumor)

_ red and hard

_ without treatment, death in 30 days _ urgent treatment

11- Chi Shi (inner thigh tumor)

_without urgent treatment death in 30 days _ without urgent treatment death in 60 days. If bilateral disease, death in 10 days

12- Pi Yung (knee abscess)

_ large size, very hard _ absence of color of skin

_ at the start, needling is prohibited (wait for the pyogenic phase)

13- Yung and Ju (vertebral tumors and abscesses)

_ red _ adheres to bone

_ urgent treatment

_ fatal prognosis _ death in 100 days if tumor located in Yang, 30 days if located in Yin

14- Tu Nia (tibial tumor)

_ red to the bone

_urgent treatment

_ benign prognosis

15- Zou Huan (tumor of internal malleolus)

_ appearance of an abscess _ skin color unchanged

_ eliminate Cold-Heat

_ benign prognosis

16- Si Zin (tumor of dorsum and sole of foot)

_ appearance of a large abscess

_ urgent treatment

_ without treatment death in 100 days

17- Li Ying (abscess of lateral side of foot)

_ big as a small digit

_ urgent treatment

_without treatment, death in 100 days

18- Tou Yung (toe abscess)

_ blackish red or black without√ red color

_urgent surgical intervention

_ fatal prognosis

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no 504/505.

Preface ..................................................................................................................... 9 Book

VI: Chapter 49: The Five Colors......................................................................... 13 (Wu Za) Chapter 50: Discussion on Courage............................................................ 43 (Lun Yung) Chapter 51: Shu of the Back........................................................................ 53 (Bei Shu) Chapter 52: Defensive Energy.................................................................... 59 (Wei Qi) Chapter 53: Discussion on Pain.................................................................. 75 (Lun Tong) Chapter 54: Celestial Age............................................................................. 79 (Tian Niam) Chapter 55: Contrary and Favorable......................................................... 97 (Yi Zuan) Chapter 56: The Five Flavors................................... .............................. .. 103 (Wu Wei) Chapter 57: Hydropsia.............................................. .............................. .. 117 (Shui Zhang) Chapter 58: Pirate Wind............................................................................. 129 (Zie Feng)

Book

VII: Chapter 59: Irregular Circulation of Wei Energy................................. 139 (Wei Qi Zi Zhang) Chapter 60: Inscriptions Engraved on Jade........................................... 151 (Wu Ban) Chapter 61: The Five Prohibitions........................................................... 171 (Wu Jin) Chapter 62: Arterial Points....................................................................... 179 (Dong Shu) Chapter 63: Dissertation on the Five Flavors......................................... 191 (Wu Wei Lun) Chapter 64: Yin and Yang and the 25 Morphotypes............................. 199 (Yin Yang Er Shi Wu Ren) Chapter 65: The 5 Musical Notes and 5 Flavors...................................... 235 (Wu Yin Wu Wei)

Book

VIII: Chapter 66: Origin of the “100 Diseases”................................................. 255 (Ba Bing Shui Sheng) Chapter 67: Practice of Acupuncture............................................ .......... 267 (Xing Zhen) Chapter 68: Above the Diaphragm.................................................. ......... 273 (Shang Ge) Chapter 69: Panic and Fit of Rage: Aphonia........................................... 279 (Yu Que Wo Ren) Chapter 70: Cold-Heat.................................................................................. 285 (Han Re) Chapter 71: Perverse Guest........................................................................ 291

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(Xie Ke) Chapter 72: Celestial Relationships.......................................................... 313 (Zhong Tian) Chapter 73: Ability in the Practice of Acupuncture............................. 325 (Guan Nang) Chapter 74: Dissertations on Diseases and Examination of the Skin of the Forearm..................................................... 343 (Lun Xi Zhan Chi) Chapter 75: Effects of Needling on the Source Energy and Perverse Energy................................................................. 359 (Ci Jie Zhen Xie) Book IX: Chapter 76: Movements of Wei Energy................................................... 393 (Wei Qi Xing) Chapter 77: 9 Palaces - 8 Winds................................................................. 411 (Jiu Gong Ba Feng) Chapter 78: Dissertations on the “9 Needles”......................................... 427 (Jiu Zhen Lun) Chapter 79: Years and Dew......................................................................... 447 (Zue Lo) Chapter 80: Great Confusions.................................................................... 463 (Dai Huo) Chapter 81: Abscesses and Tumors........................................................... 477 (Yung Ju) Table of Contents............................................................................................... 505

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