素问·针解 Explication of the Needles

Huangdi asked: I wish to hear the explanation of the nine needles, and the principle of deficiency and excess. Qibo replied: "Needling deficiency so as to make it replete" means that heat appears beneath the needle — once the qi becomes replete, heat follows. "When it is full, drain it" means that cold appears beneath the needle — once the qi becomes deficient, cold follows. "When there is stagnant old blood, remove it" means letting out the malign blood. "When the evil prevails, deplete it" means withdrawing the needle without pressing the opening closed. "Slow then quick makes it replete" means withdrawing the needle slowly while pressing the opening quickly. "Quick then slow makes it deficient" means withdrawing the needle quickly while pressing the opening slowly. To speak of excess and deficiency is to speak of whether the qi's coldness or warmth is abundant or scant. "As if absent, as if present" means that the disease cannot readily be discerned. "Examining what follows and what precedes" means knowing the sequence in which the disease arose. In treating deficiency and excess, the physician must not depart from the proper method; "as if gained, as if lost" describes a departure from that method. The essential point of deficiency and excess is that the nine needles are most marvelous precisely because each is suited to its own particular use. The timing of supplementation and drainage corresponds to the opening and closing of the qi. That the nine needles differ in name and form is because each needle is fashioned to fully accomplish the supplementation or drainage proper to it.

In needling excess, one must wait for it to turn to deficiency: retain the needle until the yin qi arrives in abundance, and only then withdraw it. In needling deficiency, one must wait for it to turn to repletion: retain the needle until the yang qi arrives in abundance and heat appears beneath it, and only then withdraw it. "Once the channel qi has arrived, guard it carefully and do not lose it" means one must not alter the needling thereafter. "Depth and shallowness lie in the intent" means knowing whether the disease lies within or without. "Near and far are treated as one" means that shallow and deep needling await the same signs before completion. "As if approaching a deep abyss" means one dares not be careless. "The hand as if grasping a tiger" means one wishes it to be firm and resolute. "The spirit should not be occupied by the multitude of things" means calming one's intent and observing the patient without glancing left or right. "The purpose should admit no deviant descent of the needle" means wishing the needle to enter upright and true. "One must rectify the spirit" means wishing to gaze into the patient's eyes so as to govern their spirit, thereby making the qi move with ease.

What is called "Three Li" lies three cun below the knee. What is called "the instep point" is found by raising the knee, whereupon the dividing line becomes easy to see. "Great Void" is found by raising the foot, at the place where the shin bone alone forms a hollow. "Lower Ridge" is the place of depression.

Huangdi said: I have heard that the nine needles correspond above to heaven and earth, the four seasons, and yin and yang. I wish to hear their model, so that it may be handed down to later generations as a lasting standard. Qibo said: One is heaven, two is earth, three is man, four is the four seasons, five is the five notes, six is the six pitch-pipes, seven is the seven stars, eight is the eight winds, and nine is the nine fields — the form of the human body corresponds to all of these, and each needle has that to which it is suited; hence they are called the nine needles. Man's skin corresponds to heaven, his flesh to earth, his vessels to man, his sinews to the seasons, his voice to the notes, the union of yin and yang qi within him to the pitch-pipes, his teeth, face, and eyes to the stars, the outgoing and incoming of his breath to the winds, and his nine orifices together with his three hundred sixty-five connecting vessels to the fields. Hence the first needle treats the skin, the second the flesh, the third the vessels, the fourth the sinews, the fifth the bones, the sixth regulates yin and yang, the seventh benefits the essence, the eighth dispels wind, and the ninth opens the nine orifices and clears the qi of the three hundred sixty-five joints — this is what is meant by each having its own particular office.

Man's heart and intent correspond to the eight winds; man's qi corresponds to heaven; man's hair, teeth, ears, eyes, and the five sounds correspond to the five notes and six pitch-pipes; man's yin and yang vessels together with his blood and qi correspond to earth; man's liver and eyes correspond to the number nine, as do his nine orifices and three hundred sixty-five connecting vessels. The unity of man serves to observe motion and stillness; heaven's duality serves to examine the five colors, to which the seven stars correspond in judging whether the hair is lustrous; the oneness of the five notes serves to examine gong, shang, jue, zhi, and yu, to which the surplus and insufficiency of the six pitch-pipes correspond; earth's duality serves to examine height and depth and their surplus; the unity of the nine fields, with its single joint and transport-point, corresponds to this in examining the closing of the joints. The threefold division of man varies: in one part one examines the teeth, where discharge is heavy and blood scant; in its tenfold division, the variation at the corners; in its fivefold division, one examines slowness and urgency; in its sixfold division, insufficiency; in its threefold division, cold at the joints; in its ninth division, the four seasons. Man's cold, warmth, dryness, and dampness correspond each to one of the four seasons, whereby one examines their contrariety; each of the four directions is to be explained in turn.