灵枢经·逆顺肥瘦 Compliant and Contrary Flow in the Fat and the Thin

Huangdi asked Qibo: "I have received instruction from you, Master, in the way of the needle, and its many aspects have all been made clear to me. Yet the way you apply it seems as effortless as if something were simply released, and there appears to be nothing fixed or rigid about it. Is this mastery something you gained through long study and practice, or does it arise in your mind through careful observation of things?" Qibo said: "Sages, in practicing the Way, accord above with Heaven, accord below with Earth, and accord in the middle with human affairs. There must always be a clear method by which measures and numbers are established, and models and standards by which things are checked and verified, before the teaching can be transmitted to others. Thus a craftsman cannot set aside the foot-rule and simply guess at length, nor cast off the ink-line and expect to strike a level. Nor can an artisan dispense with the compass and still draw a circle, or discard the square and still form a right angle. To know how to apply these instruments is simply to make use of the natural properties of things — it is a teaching easily put into practice, the constant principle of compliant and contrary flow."

Huangdi said: "I wish to hear what is meant by according with the natural properties of things." Qibo said: "If one stands over a deep channel and breaches it, the water will drain away of itself without the need for great effort. If one follows an already-cut, obstructed watercourse and breaches its blockage, the channel can be made to flow through freely. This is a way of speaking about the smoothness or roughness of qi, and the clarity or turbidity of blood and fluids, and about the compliant or contrary directions in which they travel."

Huangdi said: "I wish to hear whether people who are fair or dark, fat or thin, short or tall, each have their own proper measure for needling." Qibo said: "When a person is in the prime of life, robust and large, with blood and qi abundant and full, and skin and flesh firm and solid, if evil qi then invades, one should needle deeply and retain the needle — such is the fat person. Consider one with broad shoulders and neck, thin flesh but thick skin, and a dark complexion, with heavy, drooping lips — such a person's blood is dark and turbid, and the qi is rough and slow-moving. In temperament, such a person tends to be greedy in taking and giving. In needling this type, one should needle deeply, retain the needle, and considerably increase the count."

Huangdi said: "How does one needle a thin person?" Qibo said: "The thin person has thin skin and a pale complexion, with lean, spare flesh, thin lips, and a light manner of speech. Such a person's blood is clear and the qi flows smoothly; qi is easily lost and blood is easily damaged. In needling this type, one should needle shallowly and withdraw the needle quickly."

Huangdi said: "How does one needle an ordinary person?" Qibo said: "One observes whether the complexion is fair or dark and regulates accordingly for each. In one who is upright and of generous, substantial build, the blood and qi are harmonious and well regulated; in needling this type, one need only follow the ordinary measure without deviation."

Huangdi said: "How does one needle a robust man of sturdy bone?" Qibo said: "In needling a robust man of sturdy bone, with firm flesh and supple joints, of imposing bearing — if such a person is of a heavy, ponderous constitution, the qi will be rough and the blood turbid; in needling this type, one should needle deeply and retain the needle, considerably increasing the count. If such a person is of a vigorous, forceful constitution, the qi will flow smoothly and the blood will be clear; in needling this type, one should needle shallowly and withdraw the needle quickly."

Huangdi said: "How does one needle an infant?" Qibo said: "In the infant, the flesh is tender and delicate, the blood scant and the qi weak. In needling this type, one should use the fine hair-needle, insert it shallowly, and withdraw it quickly; this may be done twice a day."

Huangdi said: "What is meant by standing over a deep channel and breaching it?" Qibo said: "When the blood is clear and the qi turbid, if one drains it rapidly, the qi will become exhausted." Huangdi said: "What is meant by following an obstructed watercourse and breaching its blockage?" Qibo said: "When the blood is turbid and the qi is rough, if one drains it rapidly, the channel can be made to flow through freely."

Huangdi said: "What is the compliant and contrary course along which the vessels travel?" Qibo said: "The three yin channels of the hand travel from the viscera to the hand; the three yang channels of the hand travel from the hand to the head; the three yang channels of the foot travel from the head to the foot; and the three yin channels of the foot travel from the foot to the abdomen."

Huangdi said: "Why is it that the Shaoyin vessel alone travels downward?" Qibo said: "It is not so. The Penetrating Vessel is the sea of the five viscera and six bowels, and the five viscera and six bowels all draw upon it. Its upper branch emerges at the pharyngeal cavity behind the nose, where it seeps into all the yang channels and irrigates all the essence. Its lower branch pours into the great network vessel of the Shaoyin, emerges at Qichong (the Qi Thoroughfare), travels along the inner border of the yin aspect of the thigh, enters the popliteal fossa, runs hidden along the inside of the shin bone, and descends to a point behind the inner ankle, where it attaches and then divides. One descending branch joins with the Shaoyin channel and seeps into the three yin channels; another branch running in front travels hidden and emerges to attach at the instep, descends along the instep, and enters between the great toe, seeping into all the network vessels and warming the flesh and muscles. Hence, when the branch network vessel becomes bound and obstructed, the instep will not move; when it does not move, this is reversal, and when there is reversal, there will be cold." Huangdi said: "How can this be verified?" Qibo said: "One guides the patient with words, palpates and tests accordingly; if the pulsation at that point is not present as it should be, then the compliant and contrary course of the flow may still be discerned." Huangdi said: "How profound indeed is the sages' practice of the Way! Bright as the sun and moon, discerning as fine as the tip of a hair — were it not for you, Master, who could expound it?"