灵枢经·九针论 Discourse on the Nine Needles

Huangdi said: 'I have heard from you, Master, of the nine needles — a subject vast and profound indeed — yet I still cannot fully grasp it. May I ask: from what did the nine needles arise, and for what reason were they so named?' Qibo said: 'The nine needles embody the great numbers of Heaven and Earth; they begin at one and end at nine. Thus it is said: the first takes Heaven as its model; the second takes Earth as its model; the third takes Man as its model; the fourth takes the seasons as its model; the fifth takes the musical notes as its model; the sixth takes the pitch-pipes as its model; the seventh takes the stars as its model; the eighth takes the winds as its model; and the ninth takes the fields of the earth as its model.'

Huangdi said: 'How do the needles correspond to the number nine?' Qibo said: 'When the sages established the numbers of Heaven and Earth, they took one and multiplied it ninefold, and thereby established the nine fields. Nine multiplied ninefold gives nine nines, eighty-one, from which the pitch of the Yellow Bell was derived — and it is to this number that the needles correspond.'

The first corresponds to Heaven. Heaven is yang. Among the five viscera, the one that corresponds to Heaven is the lung, for the lung is the canopy over the five viscera and six bowels; the skin, being the lung's outward correlate, is the yang of the body. Hence, in fashioning the needle for this purpose, one must make its head large and its tip sharp, so that it cannot penetrate deeply, and so that the yang qi may be released.

The second corresponds to Earth. That in the human body which corresponds to soil is the flesh. Hence, in fashioning the needle for this purpose, one must make its shaft tubular and its tip round, so that it cannot injure the partitions of the flesh — for if injured, the qi would become exhausted.

The third corresponds to Man. That by which a person comes to life is the blood and vessels. Hence, in fashioning the needle for this purpose, one must make its shaft thick and its tip round, so that it can press upon the vessel without sinking into it, in order to summon forth the qi and allow the evil qi alone to be expelled.

The fourth corresponds to the seasons. The seasons are when the qi of the four seasons and eight winds lodges within the channels and network vessels, giving rise to tumor-like afflictions. Hence, in fashioning the needle for this purpose, one must make its shaft tubular and its tip bladed, so that it can drain heat and let blood, thereby exhausting stubborn and chronic disease.

The fifth corresponds to the musical notes. The notes mark the division between winter and summer, divided at the hours of zi and wu, where yin and yang separate and cold and heat contend; when these two qi clash, they combine to form welling-abscess and pus. Hence, in fashioning the needle for this purpose, one must make its tip like the blade of a sword, so that it can drain great accumulations of pus.

The sixth corresponds to the pitch-pipes. The pitch-pipes regulate yin and yang and the four seasons, and correspond to the twelve channels; this is where vacuous evil lodges in the channels and network vessels, producing sudden impediment disorders. Hence, in fashioning the needle for this purpose, the tip must be as fine as a hair yet rounded at its point, with the shaft slightly thickened at the middle, so as to draw out sudden and fulminant qi.

The seventh corresponds to the stars. The stars correspond to the seven orifices of the person, where evil lodges in the channels and becomes painful impediment, joined with the channels and network vessels. Hence, in fashioning the needle for this purpose, the tip should be like the proboscis of a mosquito or gnat; it should be inserted quietly and slowly, retained gently for a long while, so that the upright qi may follow it and the true and the evil qi both depart together; the needle is then withdrawn, allowing the patient to be nourished and restored.

The eighth corresponds to the winds. The winds correspond to the eight joints of a person's thighs and arms. The vacuous winds of the eight solar terms, the eight winds, injure a person by lodging within, between the bone joints, the lower back and spine, and the interstitial spaces, producing deep impediment. Hence, in fashioning the needle for this purpose, one must make its shaft long and its tip bladed, so that it can reach deep evil and distant impediment.

The ninth corresponds to the fields. The fields correspond to the spaces between a person's joints and skin. This is where excessive evil overflows through the body, resembling the swelling of wind-water, and lingers, unable to pass through the pivoting mechanisms of the great joints. Hence, in fashioning the needle for this purpose, the tip should be like a rod, its point slightly rounded, so as to draw out great qi that cannot pass through the joints.

Huangdi said: 'Do the needles have fixed measures of length?' Qibo said: 'The first is called the chan needle — a broad-headed needle modeled after the sewing needle; it tapers abruptly to a point one and a half cun from its tip, and measures one cun and six fen in length; it governs heat located in the head and body. The second is called the round needle; it is modeled after the felting needle, its shaft tubular and its tip egg-shaped, one cun and six fen in length; it governs disorders of qi between the flesh partitions. The third is called the blunt needle; it is modeled after the sharp point of a millet grain, three and a half cun in length; it governs pressing upon the vessel to summon the qi and expel evil. The fourth is called the lancet needle; it is modeled after the felting needle, its shaft tubular and its tip bladed, one cun and six fen in length; it governs draining heat from welling-abscess and letting blood. The fifth is called the sword-tip needle; it is modeled after the edge of a sword, two and a half fen in width and four cun in length; it governs great welling-abscess and pus, where two heats contend with one another. The sixth is called the round-sharp needle; it is modeled after a fine, hair-thin needle, its tip made slightly thicker while its shaft is made slightly thinner, so that it may penetrate deeply; it is one cun and six fen in length, and governs the treatment of welling-abscess and impediment. The seventh is called the filiform needle; it takes its form from a fine hair, is one cun and six fen in length, and governs cold and heat, pain and impediment located in the network vessels. The eighth is called the long needle; it is modeled after a long, slender probe, seven cun in length, and governs the extraction of deep evil and distant impediment. The ninth is called the great needle; it is modeled after the lancet needle, its tip made slightly rounded, four cun in length, and governs the extraction of great qi that cannot pass through the joints. Thus the forms of the needles are complete — these are the rules governing the size and length of the nine needles.'

Huangdi said: 'I wish to hear how the body's form corresponds to the nine fields.' Qibo said: 'Allow me to explain how the body's form corresponds to the nine fields. The left foot corresponds to the Establishment of Spring, its days being wuyin and jichou. The left rib-side corresponds to the Spring Equinox, its day being yimao. The left hand corresponds to the Establishment of Summer, its days being wuchen and jisi. The chest, throat, and head correspond to the Summer Solstice, its day being bingwu. The right hand corresponds to the Establishment of Autumn, its days being wushen and jiwei. The right rib-side corresponds to the Autumn Equinox, its day being xinyou. The right foot corresponds to the Establishment of Winter, its days being wuxu and jihai. The lower back, sacrum, and lower orifices correspond to the Winter Solstice, its day being renzi. The six bowels and, below the diaphragm, the three viscera correspond to the central region, and its great prohibition falls on the days on which Taiyi resides there, as well as on all wu and ji days. In all nine of these cases, one does well to watch for the times when the eight solar terms fall. If welling-abscess or swelling appears on the left, right, upper, or lower part of the body governed by these regions, and one wishes to treat it, one must not lance and treat it on the very day corresponding to that region — these are what are called the heaven-forbidden days.'

When the body is at ease but the mind distressed, disease arises in the vessels, and it is treated with moxibustion and needling. When the body is distressed but the mind at ease, disease arises in the sinews, and it is treated with hot compress and stretching exercises. When both body and mind are at ease, disease arises in the flesh, and it is treated with needle and stone. When both body and mind are distressed, disease arises in the throat, and it is treated with sweet-flavored medicinals. When a person is repeatedly startled and frightened, so that the sinews and vessels fail to communicate, disease arises as numbness and insensitivity, and it is treated with massage and medicinal wine. This is what is meant by the body's condition.

As for the qi of the five viscera: the heart governs belching; the lung governs coughing; the liver governs excessive talking; the spleen governs swallowing; and the kidney governs yawning.

As for the qi of the six bowels: the gallbladder governs anger; the stomach governs rebellious qi and foul emissions; the large and small intestines govern diarrhea; when the bladder fails to control itself, this governs enuresis; and when the lower burner overflows, this governs water swelling.

The five flavors: sour enters the liver, pungent enters the lung, bitter enters the heart, sweet enters the spleen, salty enters the kidney, and bland enters the stomach — these are called the five flavors.

The five concentrations: when essential qi concentrates in the liver, this causes sorrow; when it concentrates in the heart, this causes joy; when it concentrates in the lung, this causes grief; when it concentrates in the kidney, this causes fear; when it concentrates in the spleen, this causes apprehension — these are called the concentrations of the five essential qi within the viscera.

The five aversions: the liver detests wind; the heart detests heat; the lung detests cold; the kidney detests dryness; and the spleen detests dampness — these are what the qi of the five viscera detest.

The five fluids: the heart governs sweat; the liver governs tears; the lung governs nasal mucus; the kidney governs spittle; and the spleen governs saliva — these are the sources from which the five fluids emerge.

The five forms of taxation: prolonged looking injures the blood; prolonged lying injures the qi; prolonged sitting injures the flesh; prolonged standing injures the bones; and prolonged walking injures the sinews — these are the illnesses caused by the five prolonged exertions.

The five destinations: sour flavor travels to the sinews; pungent flavor travels to the qi; bitter flavor travels to the blood; salty flavor travels to the bones; and sweet flavor travels to the flesh — these are called the five destinations.

The five restrictions: when disease is in the sinews, one should not eat sour flavors; when disease is in the qi, one should not eat pungent flavors; when disease is in the bones, one should not eat salty flavors; when disease is in the blood, one should not eat bitter flavors; when disease is in the flesh, one should not eat sweet flavors. Even if the mouth craves and desires such flavors, one must not indulge in excess — one must restrain oneself. This is called the five restrictions.

The five arisings: yin disease arises in the bones; yang disease arises in the blood; yin disease arises in the flesh; yang disease arises in winter; yin disease arises in summer.

The five evils: when evil enters yang, it causes mania; when evil enters yin, it causes blood impediment; when evil enters yang and shifts, it causes withdrawal epilepsy; when evil enters yin and shifts, it causes muteness; when yang evil enters into yin, the illness is marked by quietude; when yin evil emerges into yang, the illness is marked by irritability and anger.

The five viscera: the heart stores the spirit; the lung stores the corporeal soul (po); the liver stores the ethereal soul (hun); the spleen stores intent; and the kidney stores essence and will.

The five governances: the heart governs the vessels; the lung governs the skin; the liver governs the sinews; the spleen governs the muscles; and the kidney governs the bones.

Yangming is abundant in both blood and qi; Taiyang is abundant in blood but scant in qi; Shaoyang is abundant in qi but scant in blood; Taiyin is abundant in blood but scant in qi; Jueyin is abundant in blood but scant in qi; and Shaoyin is abundant in qi but scant in blood. Hence it is said: when needling Yangming, let out both blood and qi; when needling Taiyang, let out blood but avoid depleting the qi; when needling Shaoyang, let out qi but avoid depleting the blood; when needling Taiyin, let out blood but avoid depleting the qi; when needling Jueyin, let out blood but avoid depleting the qi; and when needling Shaoyin, let out qi but avoid depleting the blood.

The Foot Yangming and Taiyin channels stand in interior-exterior relation; the Foot Shaoyang and Jueyin channels stand in exterior-interior relation; the Foot Taiyang and Shaoyin channels stand in exterior-interior relation — these are the yin and yang pairings of the foot channels. The Hand Yangming and Taiyin channels stand in exterior-interior relation; the Hand Shaoyang and Pericardium (Heart Ruler) channels stand in exterior-interior relation; the Hand Taiyang and Shaoyin channels stand in exterior-interior relation — these are the yin and yang pairings of the hand channels.