灵枢经·邪客 The Lodging of Evil Qi

Huangdi asked Bogao: 'Now when evil qi lodges within a person, it may cause the eyes to be unable to close, so that the person cannot lie down and sleep — what qi brings this about?' Bogao replied: 'When the five grains enter the stomach, their dregs, fluids, and ancestral qi (zongqi, the qi that gathers in the chest) are divided into three separate passages. The ancestral qi accumulates in the chest, emerges through the windpipe, threads through the heart vessel, and carries out respiration. The nutritive qi secretes the fluids, pours them into the vessels, transforms them into blood, and thereby nourishes the four extremities; internally it pours into the five viscera and six bowels, in accordance with the water-clock's measured intervals. The defensive qi issues forth its fierce and swift qi, which travels first through the four extremities, between the muscles and the skin, without ever resting. By day it travels through the yang, and by night through the yin, ordinarily proceeding from the dividing space of the Foot Shaoyin channel to travel through the five viscera and six bowels. Now, when reversal qi lodges in the five viscera and six bowels, the defensive qi alone guards the exterior, traveling through the yang and unable to enter the yin. When it travels through the yang, the yang qi becomes abundant; when the yang qi is abundant, the yang heel vessel (yangqiao) becomes engorged, and the qi is unable to enter the yin; the yin then becomes deficient, and hence the eyes cannot close.'

Huangdi said: 'Good. How is this treated?' Bogao said: 'Supplement what is deficient, drain what is in excess, regulate the deficiency and excess, so as to open the pathway and remove the evil. Give the patient a single dose of Pinellia Decoction (banxia tang); once yin and yang have been made to communicate, sleep will come at once.' Huangdi said: 'Good. This is what is called opening a blocked channel, so that the channels and network vessels are made to communicate fully and yin and yang attain harmony. I should like to hear the formula.' Bogao said: 'For this decoction, take eight sheng of water drawn from a stream that has flowed a thousand li, stir it ten thousand times, and skim off five sheng of its clear portion. Boil this over a fire of reed kindling; once it boils, add one sheng of polished glutinous millet and five ge of prepared pinellia. Simmer slowly until the liquid is reduced to one and a half sheng, then remove the dregs. Drink one small cup of the broth, gradually increasing to three times a day, using the patient's response as the measure. Thus, in a case of recent onset, as soon as the cup is set down the patient will fall asleep, and once sweating occurs the illness is resolved. In a chronic case, three doses will complete the cure.'

Huangdi asked Bogao: 'I should like to hear how the joints and limbs of a person correspond to Heaven and Earth.' Bogao replied: 'Heaven is round and Earth is square; the human head is round and the feet are square, in correspondence with this. Heaven has the sun and moon; the person has two eyes. Earth has nine provinces; the person has nine orifices. Heaven has wind and rain; the person has joy and anger. Heaven has thunder and lightning; the person has voice and sound. Heaven has the four seasons; the person has four limbs. Heaven has the five notes; the person has the five viscera. Heaven has the six pitch-pipes; the person has the six bowels. Heaven has winter and summer; the person has cold and heat. Heaven has the ten days of its cycle; the person has ten fingers on the hands. The twelve double-hours correspond to the twelve toes of the feet, together with the penis and testicles, by which a person's form is completed — though a woman lacks these two members, and thereby holds the human form within her. Heaven has yin and yang; the person has husband and wife. The year has three hundred sixty-five days; the person has three hundred sixty joints. Earth has high mountains; the person has shoulders and knees. Earth has deep valleys; the person has armpits and the hollows behind the knees. Earth has the twelve channel-rivers; the person has the twelve channel vessels. Earth has springs and veins of water; the person has defensive qi. Earth has grasses and duckweed; the person has fine body hair. Heaven has day and night; the person has waking and sleeping. Heaven has arrayed stars; the person has teeth. Earth has small hills; the person has small joints. Earth has crags and rocks; the person has prominent bones. Earth has forests and groves; the person has binding sinews. Earth has gathered towns; the person has mounds of flesh. The year has twelve months; the person has twelve joints. Earth has seasons in which the grass does not grow; the person has those who bear no children. These are the ways in which the person corresponds to Heaven and Earth.'

Huangdi asked Qibo: 'I wish to hear the numbers and techniques of holding the needle, the principles of inserting the needle, the meaning of advancing and withholding it, and how one presses the skin and opens the interstices. As for the bends and turns of the vessels, the places where they emerge and enter — where do they emerge, where do they stop, where do they move slowly, where do they move swiftly, where do they enter, and how the six bowels are transported throughout the body — I wish to hear all of this in full, together with a brief account of the places where the channels diverge and separate: where they diverge to enter the yin, and separate to enter the yang. By what pathway do they proceed thus? I wish to hear the whole of this account.' Qibo said: 'What Your Majesty asks encompasses the entirety of the Way of needling.'

Huangdi said: 'I wish to hear it in full.' Qibo said: 'The vessel of the Hand Taiyin Lung channel emerges at the tip of the thumb, bends inward, follows the border between the red and white flesh, and reaches Taiyuan (Great Abyss) behind the base joint, where it lingers and pools. It then bends outward, ascends below the base joint, bends inward again, and meets the various yin network vessels at Yuji (Fish Border); several vessels converge and pour in there, and its qi flows smoothly and freely. It travels hidden beneath the styloid bone, bends outward, emerges at the Cunkou (inch-opening) and proceeds upward to the inner border of the elbow, enters beneath the great sinew, bends inward, travels upward along the yin aspect of the upper arm, enters below the armpit, bends inward again, and runs to the lung. These are the bends and turns of its course, traced forward in its natural flow and backward in enumeration. The vessel of the Heart Ruler channel (the Pericardium) emerges at the tip of the middle finger, bends inward, follows the inner border of the middle finger upward, and lingers in the center of the palm. It travels hidden between the two bones, bends outward, emerges between the two sinews at the juncture of bone and flesh, where its qi flows smoothly and freely. It ascends two cun, bends outward, emerges to travel between the two sinews, ascends to the inner border of the elbow, enters beneath the small sinew, lingers at the junction of the two bones, ascends into the chest, and internally connects with the vessel of the heart.'

Huangdi said: 'The Hand Shaoyin Heart channel alone has no transport point at the wrist — why is this?' Qibo said: 'The Shaoyin is the vessel of the heart. The heart is the great sovereign of the five viscera and six bowels, the dwelling place of essence and spirit. Its viscus is firm and solid, and evil qi cannot be admitted into it. If it were admitted, the heart would be injured; if the heart is injured, the spirit departs; and if the spirit departs, the person dies. Thus all evil that would settle in the heart instead settles in the heart's enclosing network, the pericardium. The enclosing network is the vessel of the Heart Ruler; this is why it alone has no transport point.'

Huangdi said: 'If the Shaoyin alone has no transport point, does it then never fall ill?' Qibo said: 'Its outer channel may fall ill even while the viscus itself does not; hence one selects only its channel point at the tip of the protruding bone behind the palm. As for the emerging, entering, bending, and turning of its remaining vessels, and the slowness or swiftness of their travel, all proceed just as does the vessel of the Hand Shaoyin, the Heart Ruler. Thus, as for the root transport points, in every case one selects them according to whether the qi is deficient or excess, slow or swift: this is called draining when the qi surges and supplementing when it wanes. When this is done, evil qi is made to depart and the true qi becomes firm and secure — this is what is meant by following the sequence ordained by Heaven.'

Huangdi said: 'How does one hold the needle in advancing and withholding it?' Qibo said: 'One must first clearly understand the roots and branches of the twelve channel vessels, the cold and heat of the skin, and the abundance, decline, smoothness, or roughness of the pulse. When the pulse is smooth and abundant, the disease is advancing day by day. When it is deficient and fine, the disease has long persisted and must be sustained in treatment. When it is large and rough, this indicates painful impediment (bi). When yin and yang appear as one and the same, the disease is difficult to treat. If the root and branch of the channel are still hot, the disease is still present; if that heat has waned, the disease has likewise departed. Palpate the patient's forearm, and examine the firmness or fragility of the flesh, its size, its smoothness or roughness, and its cold, warmth, dryness, or dampness. Then observe the five colors of the eyes, in order to know the state of the five viscera and determine life or death. Observe the blood vessels and examine their color, in order to know the cold, heat, pain, or impediment present.'

Huangdi said: 'As for holding the needle in advancing and withholding it, I have not yet grasped its meaning.' Qibo said: 'The Way of holding the needle requires that the hand be upright and correct, calm and still. First know whether the condition is deficient or excess, and proceed accordingly with swiftness or slowness. The left hand grips the bone, while the right hand follows along it; do not let the needle become entangled with the flesh. In draining, the needle should be held upright and correct; in supplementing, one must close the skin afterward. Assist the needle in guiding the qi, so that evil qi is made to disperse and scatter, and the true qi is able to settle and abide.'

Huangdi said: 'How does one press the skin and open the interstices?' Qibo said: 'One follows along the muscle divisions; with the left hand separate the skin, insert the needle slightly and slowly guide it upright, so that the spirit is not caused to scatter, and the evil qi is thereby made to depart.'

Huangdi asked Qibo: 'A person has eight hollows — what does each of them indicate?' Qibo replied: 'They serve to indicate the condition of the five viscera.' Huangdi said: 'How does one read them?' Qibo said: 'If the lung or heart harbors evil qi, that qi lodges in the two elbows. If the liver harbors evil qi, that qi flows to the two armpits. If the spleen harbors evil qi, that qi lodges in the two hip-thighs. If the kidney harbors evil qi, that qi lodges in the two hollows behind the knees. In every case, these eight hollows are chambers of the body's pivots and joints, places through which the true qi passes and the blood network vessels travel. Evil qi and malign blood are ordinarily not permitted to lodge and remain there. If they do lodge and remain, they injure the sinews, network vessels, bones, and joints, so that the pivots and joints can no longer bend and extend — hence contracture and spasm result.'