灵枢经·官能 Fitness for Office

Huangdi asked Qibo: 'I have heard from you, Master, of the nine needles — their applications are so numerous that they cannot all be counted. I have deduced from them and set out a summary account. Let me recite it aloud, and you attend to whether the principles are correct; where they are not, tell me, so that I may correct the Way and ensure that it may be transmitted for a long time to later generations without mishap — to be transmitted only to the right person, and never spoken of to one unfit for it.' Qibo bowed his head to the ground and made obeisance twice, saying: 'I beg to hear the Way of the sage-king.'

Huangdi said: 'The principle of using the needle is this: one must know where the body's form and qi reside — left and right, above and below, yin and yang, exterior and interior, the relative amount of blood and qi, the direction of their flow whether contrary or compliant, and the confluence of their emerging and entering — and plan one's attack upon the excess accordingly. One must know how to release knotted binding, how to supplement deficiency and drain excess, and the qi-gates above and below, so as to be clearly conversant with the four seas of the body (the seas of qi, blood, marrow, and nourishment). Examine where the disorder resides, whether cold or heat, whether draining or exposed, so as to select the appropriate points for treatment; be thorough in regulating the qi, well versed in the channels and their conduits, and in the network vessels of the left and right limbs, knowing fully where they converge. When cold and heat contend with one another, one must be able to unite and regulate them; when deficiency and excess lie adjacent, one must know how to resolve and open a way through them; when the left and right sides are not in balance, one must take hold of the imbalance and correct it. Being clear about what is contrary and what is compliant, one then knows what can be treated; when yin and yang are not at variance, one thereby knows the proper time for the disease to resolve. Examine the root and branch of the disorder, observe its cold or heat, and once the location of the evil is grasped, ten thousand needlings will proceed without mishap. To know how to employ the nine needles is to have mastered the entirety of the Way of needling.'

Be clear about the location of the five transport points and where slowness and swiftness apply, for the bending, stretching, emerging, and entering of the needle all follow an orderly sequence. Speak of yin together with yang, in accordance with the five phases; the five viscera and six bowels each have their own store; the four seasons and eight winds all partake of yin and yang. Each has its proper position, corresponding to the Bright Hall (mingtang, the nose, used in facial diagnosis); examine each region and its complexion in relation to the five viscera and six bowels. Observe where the pain lies, whether left or right, above or below, and know whether it is cold or warm, and in which channel it resides. Examine whether the skin is cold or warm, smooth or rough, so as to know the nature of the patient's distress; the diaphragm has an upper and lower aspect, so know where the qi resides in relation to it. First grasp the proper approach: where the qi is sparse, needle sparingly; go somewhat deeper and retain the needle, so that it may be advanced slowly. When great heat lies in the upper body, push the needle and draw the heat downward; when the disorder proceeds from above to below, draw it out and remove it; when a prior instance of pain is observed, always treat that point first. When great cold lies on the exterior, retain the needle and supplement; when the cold has entered the interior, drain it by way of the confluent (he) points. Where the needle cannot serve, moxibustion is appropriate. When the qi above is insufficient, push and raise it up; when the qi below is insufficient, accumulate it and let it follow its course; when both yin and yang are deficient, moxa fire alone should be applied. In reversal-cold with severe chill, when the bone borders sink and cold has spread past the knee, select Zusanli (also called Xialing). Where the yin network vessels pass, when the disorder is found, retain the needle to halt it there; when cold has entered the interior, push the needle to move it along; where a channel has sunk and collapsed, moxa fire should be applied; where the network vessels are knotted and taut, moxa fire is what treats it. When the location of distress cannot be determined, seek it below the two heel vessels (qiaomai) — yin for a man and yang for a woman; this is what the accomplished practitioner must be cautious of. Herewith the discourse on needling is complete.

In the practice of needling, there must always be method and rule. Above, observe the brightness of Heaven; below, attend to the eight upright directions, so as to ward off strange evils and to examine the common people; be thorough in distinguishing deficiency from excess, and do not offend against the prevailing evil qi. This is to obtain the numinous power of Heaven. If one encounters a year of deficient qi and attempts to rescue a patient without being able to overcome the evil, one will instead suffer calamity oneself. Hence it is said that one must know the prohibitions of Heaven before one may speak of the true intent of needling.

Take one's model from ages past, and verify it in times to come; observe what is hidden and obscure, and penetrate what is inexhaustible. What the unskilled practitioner cannot perceive is precisely what the accomplished practitioner prizes; though its form cannot be known, it seems almost as though touched by the spirit.

When evil qi strikes a person, it produces a shivering that disturbs the body's form. When a mild pathogenic influence strikes a person, it first appears faintly in the complexion, without the person being aware of it in the body itself — as though present, as though absent; as though gone, as though still there; having form yet seeming formless — none can know its true state. This is why the superior practitioner, in taking hold of the qi, rescues the disorder while it is still in its budding stage, whereas the inferior practitioner waits until it has already taken shape, and thereby allows the patient's form to be ruined.

This is why the practitioner, in employing the needle, must know where the qi resides and guard its gateway, being clear in the regulation of qi, in the proper location for supplementing or draining, in the meaning of slowness and swiftness, and in the place to be selected. In draining, one must employ the round technique: press the needle and turn it, so that the qi is set moving; withdraw it swiftly after entering slowly, so that the evil qi is thereby expelled; extend the hand to meet the qi as it comes, and enlarge the point opening somewhat, so that the qi comes out swiftly. In supplementing, one must employ the square technique: draw the skin outward on the exterior, so as to align it with the point's opening; on the left, draw the pivot of the needle; on the right, press the skin; rotate the needle slightly and advance it slowly; the hand must be upright and correct, calm and still; hold the mind firm without wavering, insert the needle gently and let it linger; once the qi descends, withdraw the needle swiftly, press the skin, and seal the outer gate, so that the true qi is preserved within. The essential point in using the needle is never to forget the spirit.

Lei Gong asked Huangdi: 'The discourse on needling states: transmit it only to the right person, and never speak of it to one unfit for it — how does one know whether a person is fit to receive its transmission?' Huangdi said: 'One assigns each person according to what suits them, entrusting them with tasks according to their particular ability, and so each is able to master their own charge.' Lei Gong said: 'I should like to hear how offices are assigned according to ability.' Huangdi said: 'One with clear eyesight may be employed to observe complexion. One with keen hearing may be employed to listen to sounds. One quick and agile in speech may be employed to transmit and expound the teachings. One whose speech is measured and calm, whose hands are skillful and whose mind is careful and discerning, may be employed to perform needling and moxibustion, to regulate the blood and qi and harmonize their various states of compliance and rebellion, and to discern yin and yang together with the various treatment methods. One whose joints are supple and sinews pliant, whose mind is harmonious and even-tempered, may be employed to guide the patient in stretching exercises and the circulation of qi (daoyin). One whose speech is sharp and cutting, and who makes light of others, may be employed to spit upon abscesses and to incant against disease. One whose fingernails are cutting and whose hands are forceful, given to injuring things in the course of their work, may be employed to press upon accumulations and suppress impediment disorders. When each is assigned according to their particular ability, the treatment method can then be properly carried out, and the practitioner's reputation will accordingly become manifest. If the wrong person is chosen, the work will not succeed, and the teacher will gain no reputation. Hence it is said: speak of it only to the right person; do not transmit it to one unfit for it — this is what is meant. As for one whose hand is forceful, one may test this by having them press upon a live turtle: place the turtle beneath a vessel, and press upon it from above; if the turtle dies within fifty days, the hand is forceful. If instead the turtle revives and lives on as before, the hand is gentle.'