灵枢经·四时气 The Qi of the Four Seasons

Huangdi asked Qibo: 'The qi of the four seasons each takes a different form, and the hundred diseases that arise each have their own origin — in moxibustion and needling, what is the fixed rule?' Qibo replied: 'The qi of the four seasons each has its own location, and the fixed rule of moxibustion and needling is to obtain the proper qi-point (qixue, acupoint). Thus in spring one selects the channels, the blood vessels, and the spaces between the flesh divisions — in severe cases, one needles deeply; in milder cases, one needles shallowly. In summer one selects the flourishing channels and the grandchild network vessels, needling at the flesh divisions so as to sever [the pathogen] from the skin. In autumn one selects the channel transport points (jingshu); when evil qi resides in the bowels, one selects the He-Sea point. In winter one selects the Well and Spring points, and must needle deeply and retain the needle.'

For warm malaria with no sweating, apply fifty-nine punctures; for wind-water swelling with distension of the skin, apply fifty-seven punctures. Wherever blood appears in the skin, remove all of it by needling. For diarrhea with undigested food, supplement above the three yin channels of the leg, supplementing Yinlingquan (Yin Mound Spring); in all these cases retain the needle for a long time, until the heat has dispersed, and then stop.

For cramping of the sinews on the yang aspect, treat the yang; for cramping of the sinews on the yin aspect, treat the yin — in both cases needle promptly. For plain water-swelling (edema without other complication), first select the point three cun below Huangu (Ring Valley), and needle it with the pi needle (a flat, blade-like needle); having needled, insert a tube [to drain the fluid], and let it flow in and be drawn out repeatedly, so as to exhaust the swelling fluid entirely — the abdomen must become firm. If the fluid drains slowly, the patient will feel vexed and oppressed; if it drains rapidly, the patient will remain calm. Needle once every other day until the swelling fluid is exhausted, and then stop. Give the patient a fluid-restricting decoction; at the time of needling, let the patient drink only this, without eating; when eating, allow no drinking; and permit no other food — this regimen continues for one hundred and thirty-five days.

For fixed impediment (zhuobi) that does not resolve, and chronic cold that does not abate, promptly select Zusanli (Leg Three Li); when it reaches the bone, the bone becomes withered and dry. For irregularity in the bowels, select Zusanli — if replete, drain it; if deficient, supplement it. For wind-malignity (leprosy-wind, lifeng), needle directly over the swelling as a matter of course. After needling, use a sharp needle to needle the site again, pressing to expel the malign qi, and stop only when the swelling is entirely gone. Let the patient eat only the prescribed diet, and no other food.

When the abdomen constantly rumbles and qi surges up to strike the chest, causing panting so severe that one cannot stand for long, the evil qi resides in the large intestine — needle the Huang Yuan (Source point of the Vitals), Shangjuxu (Upper Great Hollow), and Zusanli. When the lower abdomen pulls upon the testicles, drawing on the lower back and spine, and surges up to strike the heart, the evil qi resides in the small intestine, connecting with the system of the testicles, attaching to the spine, penetrating the liver and lung, and linking with the system of the heart. When this qi becomes excessive, reversal occurs, surging upward to strike the intestines and stomach, steaming the liver, dispersing into the huang (the region between the heart and diaphragm), and knotting at the navel. Hence one selects Huang Yuan to disperse it, needles the Taiyin to supply it, selects the Jueyin to bring it downward, selects Xiajuxu (Lower Great Hollow) to eliminate it, and presses along the channel through which it has passed in order to regulate it.

When a person is prone to vomiting, vomits bitter fluid, sighs deeply and repeatedly, feels a fluttering unease within the heart, and fears as though someone were about to seize him — the evil qi resides in the gallbladder, and the rebellion occurs in the stomach. When gallbladder fluid leaks out, the mouth becomes bitter; when stomach qi rebels, one vomits bitter fluid — hence this is called 'vomiting gallbladder [fluid].' Select Zusanli to bring the qi downward. If stomach qi rebels, needle the blood network vessels of the Shaoyang to close off the gallbladder's rebellion, and then regulate its deficiency and excess so as to eliminate the evil qi.

When food and drink fail to descend, and the diaphragm is stopped up and impassable, the evil qi resides in the stomach duct. If it is in the upper duct, needle to press it down and cause it to descend; if it is in the lower duct, needle to disperse and remove it. When the lower abdomen aches and swells, and urination is obstructed, the evil qi resides in the triple burner; restrain it by selecting the great network vessel of the Taiyang. Observe the network vessels where they knot together with the small network vessels of the Jueyin and contain stagnant blood — if the swelling extends up to the stomach duct, select Zusanli.

To observe the complexion, examine its manner, and know whether the qi is dispersing or gathering again — one observes the color of the eyes, thereby knowing whether the disease persists or has resolved. To unify one's attention on the bodily form and listen for its stirring or stillness — one holds the Qikou (Qi Mouth) pulse and the Renying (Man's Prognosis) pulse to observe the vessels. If the pulse is firm, full, and slippery, the disease is daily advancing; if the pulse is soft, the disease is about to subside; if all the channels are replete, the disease will resolve within three days. The Qikou pulse reflects yin, and the Renying pulse reflects yang.