Nguyen Van Nghi
Tran Viet Dzung
Christine Recours Nguyen
huangdi
黃
neijing
帝
內
LINGSHU
經
Volume I
靈
Books I - III
樞
N.V.N. Edition
Translated from the French by
Edward S. Garbacz, MD
With Additional Commentary by
Sean Christiaan Marshall, D. Ac.
© Jung Tao School of Classical Chinese Medicine - 2002
To my fellow Vietnamese countrymen
For many long years, our medicine has been stifled. Today, we are
liberated and independent. Cadre must help their fellow countrymen and the
government to promote a medicine responsive to the needs of our people
supported by the foundations of Science, Nation, popular Support.
Once, our grandparents had invaluable experience treating diseases
thanks to Vietnamese medicine. In order to enlarge the medical horizon,
their descendants will have to engage in the research and coexistence of
Oriental and Western medicines.
Ho Chi Minh
(Letter to the Minister of health,
hanoi, February 27, 1955).
We insist on thanking
_ Doctor Nguyen Van Huong, former Minister of health of the
Democratic republic of Vietnam,
_ Mister Vo Van Sung, former Delegate General of the Democratic
republic of Vietnam, France,
_ Doctor Tran Quang Hy, former member of the Institute of research of
Oriental Medicine, hanoi
thanks to whom we have been able to have access to research texts of
Oriental Medicine during the long resistance (1926-1974) of the
Vietnamese people.
Nguyen Van Nghi, MD
Marseille, October, 1972
INTRODUCTION
Regrettably, the Confucian literature of our era reports: “Since the
publication of the translation of the Lingshu into popular and Western language, the
practice of acupuncture and moxabustion is lost...”. It is not about a literal loss, but a
loss in quality due to translators ignorant of all medical material, distorting the
thinking and extremely subtle facts of Oriental energetic medicine without which
acupuncture no longer makes sense.
Shu
樞
signifies “hinge” - that which fastens the strap hinge to a door to
facilitate its opening and closing.
Ling
靈
(1)
implies the qualities “of genius”, “inspired” and “marvelous”
regarding the work.
The term Lingshu has been rediscovered in the writings of Zhang Jing Yue
(1563-1640 AD):
“The essential dwelling of the mind (shen) bears the name Lingshu.”
It can be otherwise said that the human brain is the “door” of intelligence and that
all works of “genius” depend on it.
Wang Tao (702-772 AD), native of Mei county in Shangxi province and
distinguished doctor of the Tang Dynasty (618-906 AD), more precisely states
regarding this:
““Shu”
designates “Tian Shu” (“Celestial Hinge”). The celestial movements
take place in the space where the hinge and machinery (driving force) are
constantly active.
“”Lingshu”
comprises the sense of using needles and abandoning medicines.
This is why the celestial machinery is traced out in space so that each of us has the
ability to perceive it.
The space is Ling and the driving force shu. The Lingshu also includes the
notions of the jingmai, ying and wei becoming evident in our shen ling (mind,
brain).
Nothing is more marvelous than this.”
1. According to the Zhongwen Dictionary, the etymology of this character describes two sourcerers sitting around a campfire invoking a rainstorm (SCM).
According to these assertions, we may then define the word “Ling” in the
sense of “rapidity”, “agility”, that is to say, to constantly have in mind the logic of
following the spontaneous celestial (seasonal) movements . The word
“shu” is
envisioned in the sense of “motor”, the driving force, thanks to which the human
organism is able to respond with rapidity to modifications in the “5 movements” and
“6 energies”.
Ling and shu then are the indispensable movements of our energetic
system allowing us to be able to confront all pathological problems. For this reason,
the Lingshu has been the object of passionate discussion and research for over two
thousand years, and it is again at the end of the 20th century.
According to Ma yuan Tai of the Tang Dynasty (618-906 AD), author of
commentaries and explanations of the Lingshu that we possess:
“The Lingshu has
also been called “Zhen Jing” (“Classic of Acupuncture”) for the first time by Huang
Fumi, alias Shi An, of the jin Dynasty (265-420 AD)” In reality, this designation had
already been utilized by Huangdi himself in Paragraph 1 of Chapter 1 of the Lingshu:
Huangdi questions Qi Bo:
“I govern 10,000 people. I feed a hundred families and collect the taxes. I pity
myself when they are no longer provided for and moreso when they fall ill.
I therefore desire that they be protected from using toxic medicines and that
they no longer use stone-puncture, but only use the fine needles:
_to activate and aerate the jingmai
_to balance the blood and energy
_and in analyzing the “favorable/contrary” movements and
the “arriving/exiting” movements of the energy.
This therapeutic method is destined for posterity. We must therefore formulate
the rules to perpetuate them and render them easy to apply and difficult to forget,
and organize them carefully in chapters in which the notions of interior and
exterior, Beginning and Ending must be presented in a didactic and complete
manner. For this, we must consider everything and omit nothing in the writing of
the “Classic of Needles” (Zhen Jing). What do you think ?”
*
* *
We have published the Suwen before the Lingshu because:
1- The Suwen speaks on the mechanism of the triggering of illnesses. Once
the illness reveals itself, caution cannot safeguard against a future complication. For
this reason, in this classic work, it is advised to delve deeply into:
_ the origin of yin and yang, cold and heat
_ the preservation of yin, dietary hygiene and the behavior of the
individual
_ the phenomena of stimulation and inhibition, of victory and
response of the “5 movements”
_ the favorable and unfavorable phenomena of the “6 energies”
which are the necessary conditions for the prevention of the illness, one of our
greatest everyday preoccupations.
2- The Lingshu is centered totally on therapy because pathophysiology alone
cannot ensure the longevity of illnesses.
It is the first work which teaches us:
13._ about the circulation of
ying (or rong: nutritive energy) and wei (defensive
energy),
qi (energy), xue (blood) and about the activities of the jing (channels) and
mai (vessels), zang (organs) and fu (bowels);
_ about the annual and seasonal movements of the natural world which man
must be subjected to and about the necessity of neutralizing wind;
_ about needle use, thanks to which one can open the “way”(Dao) so as to
master all aspects of the problem of the jiao-ben (summit and root) of the illness and
its treatment.
The
Suwen and Lingshu are, therefore, two critical works in service to
humanity from antiquity to our times. It is written: “Man unites with heaven and
earth and responds to the solar and lunar movements. It is in this way that the Dao of
the Santai (“The Ultimate Three”: heaven-Man-earth) is completed”. Above, the
energy of man follows the movements of the sun (traveling through the 28
constellations) and moon (Lunar phases: full moon, waning moon), and below, the
energy of man answers to the ebb and flow of the ocean. This comparative study of
man and the cosmos is also found in the analogous study of the 12 jingmai of the
human being and the 12 rivers of earth.
The Suwen constitutes the penultimate reference book of medical practice
which addresses all those who practice general medicine (phytotherapy, physical
therapies, massage therapy, etc.), while the
Lingshu is a specialty work of
acupuncture and moxabustion (Zhen Jiu). Both the Suwen and Lingshu are each
composed of 81 chapters because, according to the ancient masters: “The number 81
is the multiple of 9 (=9 x 9); 9 results from multiples of 3 (=3 x 3) and the number 3 is
the number of Santai (“The Ultimate Three”: heaven-Man-earth). The multiple of
numbers spreads out to infinity and the transmission of the Dao is eternal. All this
thanks to two works, Lingshu and Suwen.”
We will publish the Lingshu in 3 volumes of approximately 1500 pages. The
original work and commentaries belong to Ma yuan Tai and his collaborator Zhang
An Yin (2), physicians of the Tang Dynasty (618-906 AD). Our translation is complete
which allows our readers to savor the subtlety of Oriental energetic medicine. Our
commentaries are developed under the symbol “N.V.N.” (Nguyen Van Nghi).
Volume 1 consists of 3 books:
1- Book 1 concerns numerous studies:
_ the study of the use of “9 Needles” according to different techniques
_ the study of the Wu shu (5 shu-antique) points according to the principle
“Judge the origin in order to study the causes”.
_ examination of the pulses and complexions of the body (3)
_ the functions of “Opening-Hinge-Closing” of the 3 yin and 3 yang and their
clinical applications
_ the concordance and discordance of xing (bodily form) and qi (energy), jing
(principal channels) and
luo (secondary vessels)
_ the different needling techniques.
2. Designated in the text under “Commentaries” by the abridged names Ma Shi and Zhang Shi.
3. Here, complexions refers not just to the face, but the “complexions” of the xing (form); for example, the “complexions” of the skin, eyes, voice quality, nails, acupucture points, channel trajectories, etc. (SCM).
2- Book 2 concerns the following studies:
_ the “mental activities” in the maintenance of the health of the living being
_ the different pathophysiologic, diagnostic and therapeutic aspects at the
time of the manifestation and disappearance of the illness.
_ the jingmai and luobie : energetic points, emptiness/fullness, treatment.
3- Book 3 contains the following notions:
_ the jingbie (distinct channels) and their system of union.
_ the depth of needling and the duration of time to leave the needle in place.
_ the jinjing (tendinomuscular channels) and their analgesic effect.
_ the method of measurement of the length of the jingmai and the method of
determination of the topography of the points.
_ the production and distribution of ying (nutritive) and wei (defensive)
energy as a function of the
sanjiao (SJ).
_ the rules of needling and choice of points following the rules of the “Four
Seasons”; the attack on the 5 organs by perverse energy and its treatment.
_ the classification and treatment of illness caused by cold and heat. The use of
points called “windows of heaven.”
The Neijing comes before all medical texts, and we have constantly used our
knowledge and long experience in Classical Chinese Medicine to offer a translation
that is as faithful as possible. It is evident that such work cannot pretend to attain
perfection. Also, critiques and corrections will be welcomed.
Finally, we thank our readers, colleagues and friends who have understood the
necessity of having a thorough knowledge of traditional foundations and whose
loyalty is for us the most precious of encouragements and needed support for our
perseverance.
Marseilles, February 1994
15.
Book 1
Book 1 consists of 7 chapters :
Chapter 1:
“9 Needles” and “12 yuan”
(Jiu Zhen Shi Er yuan)
Chapter 2:
Origin of the shu-antique points
(Ban Shu)
Chapter 3:
Explanation of the “Little Needles”
(Xiao Zhen Jie)
Chapter 4:
Pathologic Forms of Attack on the Organs and Bowels
by Perverse energy
(Xieqi Zang Fu Bing Xing)
Chapter 5:
Origin and Gathering
(Gen Jie)
Chapter 6:
Long and Short - Hard and Soft
(Tu Yao Gong Ru)
Chapter 7:
Use of the Needles
(Guan Zhen)
no 16/17.
CHAPTER I
“9 Needles” and “12 yuan”
(Jiu Zhen Shi Er yuan)
“9 Needles” (Zhen) represent the collection of different types of acupuncture
needles used before, during and after the era of Huangdi.
“12 yuan” (sources) are the places of external gathering of the source energy
originating from the 5 organs and 6 bowels located in the interior. These source
points are specific in the treatment of the organs and bowels.
Chapter 1 of the Lingshu contains 17 paragraphs devoted to:
1 - the study of the “9 Needles”, their names, forms and different lengths, used
according to various techniques:
- rapid and slow needling
- needling “in opposition” and “in pursuit”, “in opening” and “in closing”
- needling for tonifying and dispersing effects
- needling to balance the shen
- needling and waiting for the energy
- needling and the examination of the pulses
which, at a practical level, are of prime importance.
2 - the study of deleterious illnesses caused by erroneous treatments or by poor
manipulation of the needle which emphasizes the importance of the evaluation of
the state of emptiness and fullness and the seriousness or benignness of the illness.
3 - presentation of the 12 yuan (source) points which are not only situated
between the elbows and hands and between the knees and feet, but also in the
thoraco-abdominal region. These points must be used systematically in all cases of
energetic problems of the 5 organs and 6 bowels. The study of these yuan points leads
to that of the Wu shu points (the 5 shu antique points): jing, ying, shu, jing and he
and their relationships to the organs and bowels.
All these problems are presented in the chapter aptly entitled:
“9 Needles” and
“12 Yuan” (Jiu Zhen Shi Er Yuan).
PARAGRAPH 1
18.
Huangdi questions Qi Bo:
“I govern 10,000 people. I feed a hundred families, and I collect
the taxes from them. I pity myself when they are not provided for and
especially when they fall ill.
I therefore desire that they be protected from toxic medicines and
that they no longer use lithopuncture, but only use the fine needles:
- to activate and aerate the jingmai
- balance the blood and energy
- and analyze the “favorable/contrary” movements and the
“entering and exiting” movements of the energy.
This therapeutic method is destined for posterity. We must
therefore formulate the rules to perpetuate them and render them easy
to apply and difficult to forget, and organize them together carefully in
chapters in which the notions of interior and exterior, Beginning and
Ending must be presented in a didactic and complete manner. For that,
we must consider all and omit nothing in the drafting of the “Classic of
Acupuncture” (Zhen Jing). What do you think about this?”
EXPLANATION AND COMMENTARIES
I - Ma yuan Tai (Ma Shi) explains:
“It is written in “The Annals” (Ban Qi) that the emperor had divided the earth into “jing” and had invented the system of measure “Bo” (“foot” = measure of length) to divide up the jing into “Mu” where he cultivated the 5 grains (5 types of rice) to feed the people and be paid taxes. This notation explains the phrase: “I govern 10,000 people. I feed a hundred families and I collect the taxes.”
In this paragraph, Huangdi seeks to define the foundation of acupuncture, and Qi Bo contemplates over it to compose the texts.”
II - Zhang An Yin (Zhang Shi) comments :
“ ... If the peasant falls ill, he can neither work the earth nor provide for his needs. Therefore, the emperor created the methods of “9 Needles” and “Fine Needles” which he wished to perpetuate.
All medicines, whatever their origin, are toxic; lithopuncture was used to evacuate
perverse energy. These two methods are “resolvents” and “dispersants’. 19.
“Favorable and contrary movements” are transmitted by the blood and energy, and the “movements of “exiting and entering”” are the sites of reunion by which the energy is secreted to the exterior and regains the interior (internal and external trajectories).
Man lives thanks to the energy of heaven and earth. The yin and yang of man, obeying the reason of heaven and earth, circulate in perpetual fashion because everything stopping is a sign of disease. Based on the Dao of heaven and earth, Huangdi invented the method of the “9 Needles” so that the yin and yang, blood and energy of man follow the cosmic rhythm. Knowing this principle well, one cannot forget the “channels” and “rules”, that is to say, the “routes” and “directions”, the “knots” and “framework”.
Figure 1
Plan of rice fields in the era of ancient China (land divided into 9 plots).
In this chapter of the “9 Needles”, Huangdi mentions the “Fine Needles” and Qi Bo indicates the “Little Needles”. Does there exist then, other than the “9 Needles”, a category of “Little Needles”?
The sage utilizes “9 Needles” based on the numbers of heaven and earth which begin with the number 1 and end with the number 9. The multiple of 9 (9 X 9 = 81) conforms to the number of Huang Zhong.
The use of the “9 Needles” associated with the “Little Needles” permits the reuniting of the number 5 of yin and the 5 flavors with the numbers of Xia Du (I Jing: “Book of Changes”) in order to carry on the work of Fu Xi and Shen Nong. As a result, the development of the technique of needling based on the study of Liang Yi and Si Shang and the even and odd numbers of the Xia Du (I Jing) precedes the method called “mastery of self” and the method of government of the country and of pacification because the people are the basis of the state.
20.
III. N.V.N.
In ancient China, each rice paddy had the shape of an ideogram (not “jing”) divided into 9 parcels (see Figure 1). Each parcel was divided into 100 “Mu” (1 Mu = 3600 m2).
The central parcel belonged to the state and the other 8 peripheral parcels belonged to the 8 rice-cultivating families. These 8 families used not only their land, but also that of the state. At the time of the rice harvest, the state received its share of 1/9th of the crop in the form of taxes known as “jing taxes”.
PARAGRAPH 2
Qi Bo:
“That His Majesty permits me to show him with order all that
I know, beginning with the number 1 and ending with the number 9.
In effect:
_ The “knot and ankle” (1) of the “little needles” resides in the
difficulty of putting into practice simple words.
The inferior doctor deals only with the form (xing); the good
doctor keeps watch over the jing shen (essence-mental) of the illness in
marvelous fashion.
At the moment when the guest is still at the door, there is no
illness; how then can one know the etiology? The skill of needling
resides in the speed or slowness of the needle.
_ The inferior doctor only attends to “guan” (joints, barriers).
_ The good doctor becomes attached to “go” (movement, driving
force). These movements do not become detached from the “xue” (2, 3)
(points); they are delicate and sublime.
At the moment of the arrival of the energy, he does not deviate by
the minutest amount, and when he ignores this, he attains no result.
It is then necessary to know the movements of arrival and
departure of the energy well in order to intervene in time. The inferior
doctor ignores this rule; the good doctor respects it.
_ Needling performed at the moment of departure of the energy is
“contrary”, and needling at the moment of arrival is “favorable”. To know
the contrary and favorable and bring ones knowledge to the
determination of the regulation is to attain the height of the
acupuncture technique.”
EXPLANATIONS AND COMMENTARIES:
21.
I- Ma Shi comments:
In Chapter 74 (“Great Study on the True Basic Notions”) of the Suwen, we have also noted the phrase: “To know “contrary” and “favorable” well is to intervene in time without error”. But the spirit of this phrase concerns the “summit” and “root” and not the needling technique per se. The meaning varies, therefore, within this context.
The previous paragraph explicitly demonstrates the “knot and ankle” of the “little needles” and the reasoning of the method of acupuncture.
It is easy to speak of the “knot” and ”ankle” of the little needles, but difficult to put into practice. The inferior doctor, like a little worker, holds obstinately to the prestige and principle of the technique. The good doctor instead closely follows the jing-shen of the individual because,
1. Term used symbolically to convey what is essential, most important or the key element of a concept (ESG).
2. Literally, “holes”; acupuncture points (see Chapter 60 (“Dissertation on the Bone Holes”), Suwen, Volume III, NVN Ed.). 3. Dr. Vannghi likened the xue to “chiney pots” or ventilation conduits. Thus, acupuncrtue points serve as a means of energetic “aeration” between the cosmos and the internal milieu (ESG).
within the emptiness and fullness of the energy and blood, a good tonification or dispersion depends not only on the needling technique, but also on the state of the shen which is nothing but the essential energy of man.
The phrase “... in marvelous fashion” implies that the essential energy must always be safeguarded. Infiltration of perverse energy into the organism is short-lived, like a guest passing through; this is why one gives it the name of “guest energy”.
The phrase “... The guest is again at the door” means to say that the perverse energy tends to penetrate into the “doors” (energetic points). If one does not succeed in determining it or the channels affected, how can one dare to study etiologies to therapeutic goals? Once the cause of the illness is known, one can carry out the method of needling, but the skill resides in the rapid or slow implantation of the needle.
“The inferior doctor only attends to the 6 “guan” (joints of the 4 limbs)” because he ignores the entering and exiting movements of the essential energy and perverse energy. “The good doctor only attends to the “go” (movement, mobility, driving force)”, that is to say, to the movements of departure and arrival of the energy. These movements do not leave the xue (“holes”). The energy of man can be found in a state of emptiness or fullness; the needling can be rapid or slow. After placing the needle in permanently, one obtains deqi (arrival of the energy); one must
conserve it and not lose it. 22.
At the time of fullness of the energy, one must not tonify; this is why “at the moment of arrival of the energy, one must not go to meet it”. At the time of emptiness of the energy, one must not disperse; this is why “at the moment of departure of the energy, one must not go to pursue it.”
If one knows “go” (movements, driving forces), one must penetrate (needle) them without the slighest deviation (that is to say, needle exactly in its center); If one does not know them, no result is obtained; that is to say, one ignores the emptiness and fullness and the application of tonification and dispersion in the case of exhaustion of the blood and energy, responsible for the stagnation of perverse energy. This is why it is necessary to clearly determine the contrary and favorable movements, the emptiness and fullness, to apply the needle at the opportune moment. The inferior doctor becomes confused and fails to appreciate the marvels of the energy; only the good doctor is capable of delving deeply into the method of the use of the needles”.
II - Zhang Shi explains:
_ “The inferior doctor only deals with the form” means that he only needles the skin, flesh, muscles, vessels and bones.
_ “The good doctor keeps watch over the jing shen” means to say that he knows how to determine the emptiness and fullness of the blood and energy in order to apply the methods of tonification or dispersion.
_ “ ... in marvelous fashion”: praise addressed to good doctors who know how to keep watch over and direct the jing shen.
_ “The door” designates the place of entry and exiting of the essential energy, and “the guest is again at the door” denotes that the perverse energy is again found at the place where the essential energy enters and exits.
_ “Etiology”, the word which implies that one must determine the location of the illness before applying acupuncture.
_ “Slow and rapid”, words designating slow and rapid needling
_ “The inferior doctor keeps watch over the guan”. Guan are the generic names for the joints of the 4 limbs.
_ “The good doctor becomes attached to the movements of “go” (driving force)”; in other words, he knows perfectly the precise spot where the energetic points occur. Then the needling is as rapid as an arrow flying from a crossbow.
_ “These movements do not become detached from the “holes” (points)”. This means that the good doctor recognizes in precise fashion the points to needle.
_ The perverse energy and essential energy are sometimes in fullness, sometimes in emptiness. One must clearly know their “arrival” and “departure” at the level of the points. Needling must be exact without deviating even the slightest from its center.
_ The moment of arrival of the energy is the moment of fullness of the perverse energy and emptiness of the essential energy. Therefore, one must not hurry to go to meet it to tonify it. In other words, one must not tonify when the perverse energy is in a period of virulence.
_ When the perverse energy is moving away, this is the period of weakening of the
essential energy. Therefore, one must not hurry to pursue it to disperse it at the risk of injuring the essential energy. It is necessary then to wait for just the right moment when “the energy is underway, arriving or leaving” to intervene as rapidly as an arrow drawn in a crossbow.
23.
In Chapter 27 (“Separation and reunion of Pure energy and Perverse energy”) of the Suwen, it is said :
“If one does not discern the perverse energy in a clear-sighted manner and if one uses acupuncture to disperse it after its departure, the essential energy escapes without returning and
the perverse energy comes back to worsen the illness”.
For this reason, it is mentioned: “When the perverse energy has left, one must not pursue it, and, when the perverse energy has arrived, one must not hurry to go to meet it.” This assertion means that one must aim for just the right moment of arrival or departure of the perverse energy to disperse or tonify because needling performed too early or too late causes defeat. This is why the inferior doctor who ignores this principle is an insignificant doctor. An erroneous
application of tonification or dispersion injures the blood and energy and does not eliminate the perverse energy.
Knowledge of the moment of departure and arrival of the perverse energy therefore
permits determining the emptiness and fullness of the essential energy in order to needle in time. This fact is also ignored by the inferior doctor; it is that which is the difference between him and the good doctor.
At the moment of departure of the energy, the perverse energy and essential energy are simultaneously empty or in a weak state. A tonification or dispersion performed on the field is a favorable action.”
This is why “to know the contrary is to know how to act without error”; this means knowing the opportune moment to needle.
“To go against it and eliminate it”, is dispersion, that which brings about emptiness. “To go in pursuit of it and aid it” is tonification, that which brings about fullness. In this way, to know the reasoning behind “against” and “pursuit” is to widely possess the techniques of acupuncture.”
III - N.V.N. :
All oriental methods and reasoning, in a general manner, follow a logical progression comprised of its own appropriate laws.
The drafting of a book, even a medical one, must also conform to these same laws, with its chapters, table of contents, orderly diagrams of “numbers 1 to 9 “. These numbers are not just a simple numerical order, but possess a qualitative and progressive value.
The “knot and ankle” of the “little needles” is easy to speak of but difficult to practice. The inferior doctor sees only the form (xing), while the good doctor studies the jing shen of the person to determine the excessive and insufficient states of the blood and energy. In other words, he masters a very effective technique which consists of “observing the illness” in order to
appreciate the emptiness and fullness of the shen qi (mental energy); he understands the reason for the fixation of perverse energy within the organism and knows in precise fashion its sites of infiltration. These facts are vital because, without them, it is impossible to define pathologic characteristics.
manipulation of the needle. In this regard:
_ the inferior doctor knows only the energetic points located near joints;
_ the good doctor bases his judgment on the constitution, diet and the psycho-affective state of the patient to determine the mechanism of emptiness or fullness, the processes of excess and insufficiency of the perverse energy, because the alteration of the organism is intimately linked to that of the points of acupuncture, sites of appearance of the very subtle reactions of
emptiness and fullness, excess and insufficiency.
24.
When the perverse energy is in fullness, it is advised against to use the method of tonification which would reinforce it. When it has left, the method of dispersion to expel it is contra-indicated.
The physician must know the reason for the evolutive mechanism of the illness to analyze the phenomena of “coming and going”, “entering and exiting” of the perverse energy in order to use the method of tonification in time and without error. One who does not know this reasoning of these pathological processes cannot perform in time the desired needling during tonification and dispersion, like an arrow on a tense bowstring which does not slacken at the opportune moment.
The one who uses acupuncture must know the movements of coming and going (of arrival and departing) of the energy, that this movement can be “contrary” or “favorable”, excessive or insufficient. By that, one must know the duration of the needle in situ. The inferior physician ignores this fact; only the good physician clearly comprehends it and uses it in marvelous fashion.
Concerning “favorable” (shung) and “contrary” (ni) movements, when the pulse of the energy is empty and small, it is contrary; and when the pulse of the energy that has already arrived is harmonious and balanced, it is favorable. Understanding the systems of movements of arrival and departure and of the favorable and contrary movements, therefore, permit performing the needling at the moment desired with certainty.
One must base his judgment on the direction of orientation of the departure and arrival of the jingmai in order to carry out the needling. If the movement of arrival is contrary, one must disperse to eliminate the fullness; then the perverse energy passes from fullness into emptiness. In the opposite case, when the movements are favorable, one must follow the path of the
circulation in order to perform the needling, and the method of dispersion (to go against in order to eliminate) and the method of tonification (pursue to augment) are intended to effectively harmonize the emptiness and fullness. In this manner, to grasp this “bolt and hinge” is to clearly understand the essential reasons for needling.
PARAGRAPH 3
“
In a general way, in the event of [therapeutic] victory, the
principles of use of the needles consist of rendering full the empty,
excreting the too full, removing blood stasis and weakening the
perverse energy. According to the Dao Yao (4): “To transmit to the needle
first slow then rapid movements is to render full, and to transmit to the needle first
rapid then slow movements is to render empty. To speak of emptiness and fullness is
like “to not have” and “to have”. To judge before and after is like “to survive” and
“to die”; this is emptiness and this is fullness; it is like “gain” and “loss”.
EXPLANATIONS AND COMMENTARIES
25.
I- Zhang Shi explains :
“Render full the empty” means to say that, in the event of emptiness of the radial pulse, one must tonify.
“Excrete the too full”: In the event of fullness of the radial pulse, one must disperse. “Remove stagnated blood”: Eliminate contaminated blood accumulated within the vessels. “...Weaken the perverse energy ...in event of [therapeutic] victory”: In event of fullness of the perverse energy at the level of the channels, one must disperse to evacuate it.
“First slow then rapid movements”: Slow implantation of the needle and rapid removal. “First rapid then slow movements”: Rapid implantation of the needle and slow removal. “To speak of emptiness and fullness”: Fullness implies the sense of the presence of the essential energy, and emptiness, the absence of the perverse energy.
“To judge before and after”: To examine the state of emptiness and fullness in order to apply tonification and dispersion.
“This is emptiness, this is fullness”: During tonification, it is necessary to tense the body as in a moment of receiving something, and during dispersion, it is necessary to relax it as in a moment when one loses something.
Such are the words on the technique of the “Little Needles”. II - N.V.N. :
This important paragraph merits a more precise interpretation.
The principles of use of the needles consist of applying the method of tonification in syndromes of emptiness to reinforce the potential of the essential energy and the method of dispersion in syndromes of fullness to excrete the perverse energy.
In chronic syndromes of compression/accumulation of the blood, it is also necessary to use the process of dispersion to combat the stasis of perverse energy.
In the evolutive period of the illness, the perverse energy triumphs over the essential energy; one must also use the method of dispersion to evacuate the perverse energy which, in fullness, then becomes empty.
The Dao Yao states: “Slow insertion and rapid withdrawal of the needle retains the essential energy which is not evacuated to the exterior; this is the method of tonification. Rapid insertion and slow withdrawal of the needle exteriorizes the perverse energy by the route of insertion; this is the method of dispersion.”
To speak of emptiness and fullness also implies to speak of the sensation of the arrival of the energy (deqi). The departure and arrival of the energy are at once slow and rapid as if it was alternately present or absent. Therefore, the examination of these phenomena must be meticulous. III. S.C.M.:
While bearing in mind that this “emptiness and fullness” may refer to the states of either the perverse energy or essential energy, clinically, one would always disperse the perverse energy and tonify the essential energy.
PARAGRAPH 4
26.
“Knowledge of the “knot and ankle” of the emptiness and fullness
is an excellent standard by which to comprehend the chapter on
“9 Needles”; thus, tonification and dispersion are based solely on the
manipulation of the needle.
In order to disperse, first hold the needle and push it in rapidly,
then withdraw it slowly. Moving the yang energy away by advancing
the needle, the perverse energy will be secreted.
In order to tonify, press on the point with the finger before
performing a slow needling. This technique bears the name “make the
heat enter”, to allow ofr the prevention of dispersal of the blood and
secretion of the energy. Tonification implies the sense of “submission”
(obedience) whose ideogram expresses the image of a light step, of a
light support (of the finger), like the poise of a mosquito. Setting the
needle in place is slow, and the withdrawal of the needle is as rapid as
the shooting an arrow from a crossbow. The left hand is associated with
the right in order to stop the energy. The “door” being closed, the
energy is in fullness in the interior, preventing the formation of blood
stasis. In the event of stasis, one must eliminate it rapidly.”
EXPLANATIONS AND COMMENTARIES
I - Ma Shi emphasizes :
“This paragraph is presented in Chapter 3 (“Explanation of the Little Needles”) of this same work, but in a slightly different fashion.”
II - Zhang Shi explains :
“This paragraph completes the previous one and explains the “knot and ankle” of needling based on emptiness and fullness.
In practice, if the radial pulse is in emptiness, it is necessary to tonify; this is why it is said: “render full the empty”. If it is full, it is necessary to disperse; this is why it is said: “Excrete the too full”.
The radial pulse is the site of gathering of the “hundred vessels” and site of examination of emptiness and fullness. Chapter 7 (“Special Study on Yin and Yang”) of the Suwen also states: “Qi Kou (radial pulse) becomes the “inch” (thumb) pulse in order to determine life and death; in the event of blood stasis, one must eliminate it... . “
If the perverse energy at the level of the channels is in fullness, one must disperse. This is why it is said : “render empty in the event of victory of the perverse energy”. In the Dao Yao, it is also stated : “In order to tonify, implantation of the needle is slow and withdrawal rapid; and in order to disperse, the insertion of the needle is rapid and the withdrawal slow.” It is also stated differently: “Slowly then rapidly, this is fullness; rapidly then slowly, this is emptiness.” 27.
Fullness and emptiness owe their name only to the presence or absence of the energy. The energy makes up part of the group “without form”; it seems “to exist” and “to not exist”.
Examining before and after the needling, the fullness seems to disappear then appear, and the emptiness to appear then disappear because:
_ for the energy to be in fullness, it is necessary that it be in emptiness before becoming full.
_ for the energy be in emptiness, it is necessary that it be in fullness before becoming empty.
appears always to exist.
Emptiness and fullness are like “gain” and “loss”. At the moment of dispersion to render empty, the patient experiences a sensation of quivering as if he had lost something; and at the moment of tonification to render full, the subject experiences a sensation of tension as if he had received something. The patient feels these sensations because emptiness and fullness come from the same energy and are like a “gain” or a “loss”.
Emptiness and fullness are the genuine “knot” and genuine “ankle” of the acupuncture technique and the true marvelous expression of “9 Needles”. One must know the emptiness in order to tonify and the fullness in order to disperse at the opportune moment. The technique is therefore simple since it is based on the manipulation of a single needle.
In order to disperse, one must firmly hold the needle, implant it rapidly and withdraw it slowly. If one can dissipate the yang energy during the manipulation to advance the needle, the perverse energy will be eliminated.
In order to tonify, press firmly on the point with the finger before needling. This
technique is called “Entry of the heat”; it prevents the dispersal of the blood and secretion of the energy.
Tonification implies the sense of “pursuit” with contemplation as if, desiring to leave, one constructed a plan; as if already at the door, one considered what one was going to do, or else, as if one held out his hand toward an uncertain support... . It is like the movement of a fly which is poised. But to withdraw the needle, it evokes the image of the break in the arc of a bowstring. All this has the same meaning as the phrase: “ First slowly then rapidly”. The right hand withdraws the needle and the left closes the point of impact of the puncture; it is what one calls the
technique of “2 hands” (left and right). At that instant, the essential energy stops in the interior and the door is closed at the exterior; the “central” energy (Zhongqi) is in fullness and the blood does not stagnate. In the event of stagnation, one must quickly eliminate it. In principle, this technique of tonification never provokes blood stasis.”
III - N.V.N. :
The essential point of the method of regulation of the emptiness and fullness is using the 9 types of needles according to the different methods of tonification and dispersion. Each of these methods has its specificity, and the needles are employed as a function of the opening and closing
of the energy. 28.
• In the process called dispersion, the insertion of the needle is rapid and withdrawal slow; the point of impact of the needle is left free because, in fact, it involves an action at the level of the external region responding to the yang. In this way, the needle has created a path of exit to facilitate the evacuation of the perverse energy.
If, in some illnesses where dispersion is obligatory, the method of heated needles is used in its place, a compression of blood and energy forms in the interior to trigger the illness called Nei Wen (mild internal heat). This Nei Wen therefore comes from blood stasis whose end result is the non-excretion of the perverse energy.
• In the process called tonification , the essential point depends on the orientation of the energy of the pulse at the moment of its departure in order to transmit to the needle movements of rotation, advancing and retreating. As a result, needling performed after the departure of the energy is absolutely in vain.
Needling to direct the energy and pressure on the point must be delicately and skillfully performed like a mosquito poised on the skin and subtly taking off, leaving the impression of still being there.
The removal of the needle must evoke the image of the precise and lightning-quick departure of an arrow. The right hand performs the process of withdrawal of the needle, the left hand compresses and blocks the point of impact of the needle to prevent the “central energy” (Zhongqi: energy of the spleen) from becoming evacuated to the exterior, like a closing a door, so
that the Zhongqi becomes full in the interior.
Such is the therapeutic method of tonification of the essential energy and of the evaluation of the perverse energy without provoking blood stasis. If, in spite of all, blood stasis forms at the level of the luomai (secondary luo vessels) after the needling, it is necessary to evacuate it by techniques of local bleeding.
PARAGRAPH 5
“Concerning technique, firmness and confidence are invaluable.
Needle vertically without angling to the right or left; focus attention on
the “specks of dust of autumn” (5, 6) and on the patient. Knowledge of the
points allows needling without danger.
At the moment of implantation of the needle, to stimulate with
attention to the yang energy and the “2 wei” without diverting the jing-
shen allows determining the persistence or disappearance of the
i l l n e s s .
Also examine the little vessels across the shu points which are
hard and solid to the touch.
EXPLANATIONS AND COMMENTARIES
I - Ma Shi explains:
“This paragraph is devoted to the technique of the manipulation of the needle. The physician must be sure of himself in order to determine in precise fashion the points of the
channel affected.
The essential feature of the method is to firmly hold the needle; this is why “firmness” is called “invaluable”. While the needle is firmly maintained in this manner, implant it vertically with dexterity without angling to the right or left; concentrate the jing shen on the needle without apprehension; the skill is extreme.
“The jing shen becomes fixed on the specks of dust of autumn” implies the sense of the concentration of the mind of the physician on the patient in order to determine the emptiness and fullness of the channel. Needling will be, in this way, without danger. This effort of concentration mobilizes the yang energy of the physician. In this manner, the “2 wei” (wei of the physician and wei of the patient) is in communion of effort and lucidity. At this moment, the mental state of the physician becomes concentrated on the patient to help him recognize if the illness persist or not. One determines the exact location of the point when, upon pressure of the
finger, a hard and firm point is felt. 29.
The essential feature for the physician is to look after his serenity in order to discern the points of the channel to attain. Such is the “knot and ankle” of the art of acupuncture.
II - N.V.N.:
The essential points of this paragraph are:
_ The art of holding the needle is extremely invaluable in the practice of acupuncture. _ During needling, one uses three fingers of the right hand (thumb, index, middle) to
5. Literally, the skill of needling resides in the spaces of “specks of dust of autumn”, an expression showing how subtle the way of dexterity is.
6. In autumn, the metal movement and quality is respponsible for the drying of leaves into dust particles...????. The Chinese character for it is sean (SCM)
firmly maintain the needle and stick it vertically into the skin without angling right or left. _ The mind of the physician must be concentrated on the body of the needle and tips of his fingers.
_ The observation must be meticulous. Attention must be focused on the mental state of the patient.
Therefore, before needling, one must :
_ become preoccupied with the mental spirit of the patient,
_ examine the emptiness and fullness of yin and yang and of the “2 wei” (7), the inviolable residence of the shen,
_ determine the state of the mental energy and energy of the organs and bowels to control the seriousness of the illness
_ and search for the existence of the little vessels (blood vessels) that cross the shu points (transporting points) to perform movements of pressure/friction in order to have a sensation of hardness that gives evidence of the formation of the accumulation of the perverse energy.
III. S.C.M:
Regarding the “inviolability” of the residence of the Shen and the “2 wei” (exterior and interior) which house the shen, one must “keep watch over” the mental state of the patient during treatment. If the patient becomes emotionally disturbed by or during a treatment, that treatment is to be terminated.
PARAGRAPH 6
30.
“Each of the “9 Needles” are totally different:
1. Chai Zhen or needle with an arrow point, 1.6 cun long.
2. yuan Zhen or needle with an oval point, 1.6 cun long.
3. Di Zhen or needle with a blunt point, 3.5 cun long.
4. Feng Zhen or needle with a triangular point, 1.6 cun long.
5. Pi Zhen or needle with a sword point, 4 cun long, 1.6 cun wide.
6. yuan Li Zhen or needle with a fine, rounded point, 1.6 cun long.
7. Hao Zhen or needle with a filiform point, 3.6 cun long
8. Chang Zhen or needle with an elongated point, 7 c. long
9. Da Zhen or needle with a wide point, 4 cun long.
7. Regarding the “2 wei”, Zhang Jing Yue’s explanation is slightly different from Ma Shi’s. According to him, “The “wei” located at the yang is the wei of the exterior. The energy of the spleen, located in the interior, is the “wei” of the organs and bowels. These two places (yang and yin, exterior and interior) are the sites where the mental energy (shen qi) gathers that must not be disturbed. During use of the needles, one must keep watch there”. Zhang Jing Yue’s explanation appears to be clearer and more plausible than that of Ma Shi.
Chai Zhen, with a wide shaft and head pointed like an arrow, is
intended to disperse yang energy.
yuan Zhen is egg-shaped and allows massage of the point before
incising the skin without affecting the flesh to disperse the energetic
p a r t .
Di Zhen, with blunted point calling to mind a barb of a grain of
rice, is intended for superficial puncture of the channels to draw the
e n e r g y .
Feng Zhen, with 3 facets, is intended to “hollow out” (enlarge)
points in individuals affected by chronic disease.
Pi Zhen, needle with a sword-like point, is intended to drain
pyogenic formations.
yuan Li Zhen, small and rounded, calling to mind the neck hair of a
fox, is intended to treat the “Bao qi” syndromes (generic name given to
chronic painful paresthesias).
Hao Zhen, fine, calling to mind the stinger of the mosquito, is
intended for needling in a lively manner. This needle is left in place a
long time to combat painful paresthesias.
Chang Zhen, long with pointed head and fine thin shaft, is intended
to treat painful syndromes of deep parts.
Da Zhen, calling to mind the shape of a stick with a rounded tip, is
intended to drain serous fluid at the level of the guan (joint =
h y d r a r t h r o s i s ) .
Such are the general features of the “9 Needles.”
31.
EXPLANATIONS AND COMMENTARIES
I - Zhang Shi explains :
“This paragraph is devoted to the description of the “9 Needles” and their uses. The “Little Needles” are developed at length in Chapter 3 (“Explanations of the “Little Needles””).
Knowledge of the “knot and ankle” of the emptiness and fullness is the essential basis in the practice of the “9 Needles.” That is to say that each needle type must be used wisely.
Tonification and dispersion are based on the manipulation of the needle. In other words, the “opening” and “closing” of points must be in accordance with the state of the essential energy and perverse energy.
“Push the yang energy away so that the needle advances.” here, yang energy means the essential energy. When the yang energy is pushed away, the perverse energy is driven back to the exterior.
“Make the heat enter”. When heat manifests at the point of the needle, the perverse energy is evacuated and the essential energy is not secreted to the exterior. This expression represents the action of needling during tonification and dispersion.
In the classics, it is said : “The blood is with Ying Qi, and energy is with Wei Qi.” Wei energy circulates at the same time in the yin and in the yang; this is why one uses this yin and this yang energy between “2 wei” (8)”.
In Chapter 76 (“Circulation of Wei energy”) we read: “It is imperative to wait for the energy to know where it occurs in order to apply a suitable needling; this is what one calls “timely needling”. When the illness is found within the three yang channels, one must wait for the arrival of the energy in the yin part in order to needle.”
8. See also commentary in the Zhen Jiu Da Cheng in “Art and Practice of Acupuncture and Moxabustion” Volume II, Wording 75, page 12 (N.V.N. Edition) and “Footnote 5” above.
In Chapter 75 (“Effects of Needling on the Source energy and Perverse energy”) it is also stated: “The harmony of the 6 channels (3 yin and 3 yang) is synonymous with health. If the area above the channel is in fullness, the area below is surely in emptiness and the blood does not circulate. In this case, perverse energy is certainly present in the yuan luo (secondary vessels) and is found in a state of fullness and accumulation causing a compression/obstruction of the great channels (principal channels). One must needle to disperse; this is the technique called “freeing the accumulation”. This is why, in the presence of little vessels located across the shu points of the channel (jing shu: energetic point and not the 3rd shu-antique point), they are not only visible, but indeed they give an impression of fluctuance (slightly painful) upon pressing
with the finger. (see Figure 2) 33...
“9 Needles” is the generic names given to the 9 different types of needles. Each type is used according to precise indications.
II - Ma Shi explains :
“This paragraph deals with the forms and usage of the “9 Needles”. Figures are inserted in this paragraph.”
III - N.V.N :
The explanation of Zhang Shi concerns instead the previous paragraph. That of this paragraph is presented only in a few words.
32.
Figure 2
State of emptiness of the principal channel and state of fullness of the secondary vessels. In the 1st case: tonification. In the 2nd case: dispersion.
Figure 3
The “ 9 Needles “
PARAGRAPH 7
33.
Perverse energy is at the top, impure energy is at the center and
pure, clarified energy is down below.
Needling the Xianmai (vessels of the “fossa”: vessels located at the
level of the nucha ( 9 )) excetes the perverse energy, and needling the
Zhongmai (center vessels) excretes the impure energy.
Needling too deeply submerges the perverse energy and worsens
the illness.
This is why it is said:
“The skin, flesh, muscles and vessels have their
different locations, their different illnesses and their different treatments. In the
event of fullness, do not augment the fullness; in the event of emptiness, do not
augment the emptiness. Worsen neither the insufficient nor the excessive because to
act in this manner is to worsen the illness. To needle the “5 Mai” (“5 Vessels”) is to
provoke death; to needle the “3 Mai” (“3 Vessels”) is to also provoke death; to
eliminate yin is to provoke inanition; to eliminate yang is to provoke “Kuang”
(agitation, violent madness).”
EXPLANATIONS AND COMMENTARIES
I - Zhang Shi explains:
“This chapter develops the methods of utilization of the “Little Needles” in the treatment of illnesses brought about by perverse energy and their disadvantages.
The energy of “wind, rain, cold, heat” attacks the upper part of the body. This is why it is said : “Perverse energy is at the top.”
The cereal energy (diet: drinks, food) penetrates into the stomach and becomes transformed into “jing” (“pure energy”: essence) which flows towards the lungs via the
intermediary of the spleen; this cereal energy also becomes transformed into “zhuoqi” (“impure energy”) which gathers at the level of the intestines. This transformation can occur in the course of a climatic disturbance (unbalanced cold or heat) or in the course of a diet disturbance to trigger intestinal illnesses. This is why it is said: “The impure energy is at the center”.
34.
The aggression of the clear and damp energy (humidity) of earth always begins at the feet. This is why, it is said: “The pure energy is down below.”
“Xianmai” (xian = fossa ; mai = channel-vessel) is a point of the channel located at the level of the nucha which is easily spotted. Needling this point excretes the perverse energy.
“Zhongmai” (zhong = center) designates Sanli (St 36), he point of the Foot Yangming. “Needling too deeply submerges the perverse energy” means that it is not necessary to needle Sanli (St 36) too deeply when the illness is superficial at the risk of conducting the perverse energy more toward the interior.
“Skin, flesh, muscles and vessels have their different places... .” means that the jingluo (principal and secondary channels) have a specific location and a specific function. This is why deep or superficial illnesses manifest at different levels (either at the skin, flesh ...). It is at these levels that one must needle according to the principle “Do not render full what is already full; do not render empty what is already empty... .” On the other hand, if one weakens the body in an insufficient state and if one reinforces the perverse energy in a state of fullness, one worsens the illness.
“5 Mai” designates the 3 yang channels (taiyang, yangming and shaoyang). Too intense a dispersion of the yang energy is responsible for “inanition”. This term encompasses the sense of fright, collapse and weakness.
“To eliminate yin is to provoke death” means to say that needling the point Wuli (LI 13) can carry with it serious accidents. In Chapter 60 (“Inscriptions Engraved on Jade”) of the Lingshu, it is stated: “After having performed 5 times the reducing method of the energy at the level of Wuli and after having awaited the arrival of the energy (deqi), if withdrawal of the needle is done after the departure of the energy, the energy of the organ will become exhausted”.
“To eliminate the yang provokes kuang (violent madness)” means to say that needling the point Wuli can carry with it a loss of the yang energy of the patient. This phrase explains the dangers of an erroneous needling.”
II - Ma Shi specifies :
“This paragraph defines three types of perverse energy (xieqi: cosmic energy), impure energy (zhuoqi) and clear energy (qingqi) and emphasizes the disadvantages of needling too deeply thereby avoiding errors.
Perverse energy attacks the top part of the body. This is why it is said: “Perverse energy is at the top”. This attack takes place at the points Fengmen (Bl 12) and Fengfu (GV 16).
The cereals (foods) penetrate the stomach and are transformed into energy which gathers at the lung. But during the course of unfavorable climatic changes (unbalanced cold or heat), this energy accumulates at the level of the intestines and has the name Zhuoqi (impure energy). This is why, the text states: “Impure energy is at the center”. 35.
This is why it is said: “Clear and humid energy is below”.
Needling Xianmai (Bl 12, GV 16
)
located at the top eliminates the perverse energy and that of Zhongmai (center vessel represented by Sanli St 36) evacuates the impure energy.
Needling must not be too deep because the illness is found in the superficial zone of the body. Deep needling worsens the illness. This is why it is stated: “Skin, flesh, muscles, jing and luo have their different locations.”Wuli (LI 13), belonging to the Hand Yangming, is a prohibited point. As a consequence, during dispersion, if one removes the needle in the full act of needling, and if one repeats the process 5 times, the energy of the organ will be wiped out. The term “organ” designates the Hand Taiyin (Lu) whose energy commands the “100 energetic currents”. This is why it is stated : “To eliminate yin is death” and “To eliminate yang is madness” (kuang).
III - N.V.N :
Perverse energy infiltrates into the jingluo to provoke illness.
Cosmic perverse energy (wind-cold) generally penetrates into the cephalic region at the level of Fengfu (GV 16) and Fengmen (Bl 12). One then says: “Perverse energy is at the top.”
A dietary disturbance is caused by the production of impure energy (Zhouqi). This energy accumulates within the stomach and intestines. One then says: “Impure energy is at the center.”
Cold-damp of the earth infiltrates into the organism at the level of the feet. One says then: “Clear and damp energy is at the bottom”.
This is why needling points on the head can evacuate perverse energy, and needling points belonging to earth can eliminate impure energy accumulated within the stomach and intestines.
In superficial illnesses, one must avoid needling too deeply because the perverse energy can follow the path of the needles to penetrate more deeply into the organism and aggravate the illness. This is why one says: “Skin, flesh, muscles and vessels (jingluo) are each in a well- established layer. Each illness is treated by therapeutic methods that are appropriate to it. The variety of the types of the “9 Needles” answers to that of the illnesses”.
One does not apply the tonification method in syndromes of fullness and the dispersion method in syndromes of emptiness. As a result, if, in the case of insufficiency of the essential energy, one uses dispersion and, in the case of excess, tonification, one worsens the illness.
On the other hand, in serious cases, dispersion of the energy of the yin channels of the 5 organs causes fatal accidents, and dispersion of the energy of the yang channels of the 6 bowels is responsible for a weakening that is difficult to restore. In other words, erroneous application of dispersion of the yin channels causes annihilation of the energy of the 5 organs, resulting in death; and an erroneous application of dispersion of the yang channels is the origin of violent madness (kuang).
36.
PARAGRAPH 8
During needling, if the energy does not arrive, the number of
needlings is not of importance.
Needles are used for different purposes according to their type.
The “knot and ankle” of needling consists of obtaining the arrival
of the energy (deqi) which is the mark of effectiveness.
This effectiveness is like that of the wind sweeping the clouds
away revealing the blue sky. This needling method is entirely
s u f f i c i e n t . ”
EXPLANATIONS AND COMMENTARIES
I - Zhang Shi explains:
“This paragraph defines the efficacy of needling, taking deqi as “knot and ankle”. The preceding paragraph emphasized the importance of the following axiom according to which “different illnesses are treated by different needles.”
“... like the wind sweeping the clouds away and revealing the blue sky” is an expressive image representing the dissemination of the essential energy after needling.
II - Ma Shi states:
“This paragraph defines the “knot and ankle” of needling, taking the “arrival” and “non-arrival” of the energy as the basis of explanation.
During needling, if the energy has not yet arrived, one must know how to wait and stay close by the patient to repeat the needling as many times as is necessary. The attitude of the physician is like that of a man who awaits a distinguished guest. If the energy has arrived, one should stop needling.
In the preceding paragraph, it is stated: “The skin, flesh, muscles and vessels have different locations; illnesses also have different locations and must be treated differently.” This assertion shows that needling must be done with great prudence as a function of the location of the illness.
“When the energy arrives, one must stop needling” justifies that one attaches much importance to the deqi of the needling itself. 37.
III - N.V.N. :
During needling, one does not obtain deqi when one manipulates the needle carelessly. It is necessary to begin the procedure again until it has arrived.
removal of the needle cannot be done until after obtaining the energy. The “9 Needles” are each used with a specific indication and each presents a particular form. It is advised to only use them in order to treat “the place where they will be victorious”.
One attaches importance to the deqi because the arrival of the energy is a sign of the effectiveness of needling. As stated in this paragraph, this effectiveness is comparable to that of the “wind sweeping the clouds away”.
PARAGRAPH 9
H u a n g d i :
“Tell me about the site of exit of the energy of the 5 organs and
6 bowels.”
Qi Bo:
“The 5 organs each have 5 shu-antique points, that is, a total of
5 X 5 = 25 shu points. The 6 bowels each have 6 shu points, that is, a
total of 6 X 6 = 36 shu points.
The jingmai are 12 in number, and the luomai, 15 in number,
making a total of 27 energies that ascend and descend.
The place of exteriorization of the energy bears the name jing; the
place of flowing out, ying; the place of flowing down, shu; the place of
passage, jing and the place of gathering, he.
For this reason, the 27 energies of the 27 jingluo all circulate at
the level of the 5 shu-antique points.”
EXPLANATIONS AND COMMENTARIES
I - Zhang Shi explains :
“During needle use, perfect knowledge of the places of birth and beginning, of entry and exit, of the energy is indispensable.
Ying and wei, blood and energy are produced via the cereals (food) at the level of the stomach bowel.
Ying circulates within the channels and wei outside the channels. But the blood and energy circulating within the channels saturate the exterior and flow down into the interior via the luomai.
In the interior, the 5 organs unite with the “5 movements” which is why they each have 5 shu antique points.
Among the “6 energies” coming from from the “5 movements”, one distinguishes 2 types of
fire (Ministerial fire and Imperial fire). 38...
The jingmai are 12 in number because they belong to the 6 organs and 6 bowels.
The luomai are 15 in number because they belong to the 12 jingmai, to 2 curious vessels (renmai and Dumai) and to the spleen (Dabao, Sp 21, “great luo”).
The 27 energies of these 12 jingmai and 15 luomai (27 jingluo) enter and exit at the level of the 4 limbs, between the knees and toes and the elbows and fingers.
The site of departure of the energy is the jing point, the place of flowing out in a trickle, the ying point, place of flowing down, the shu point, place of flowing out strongly√√, the jing point, place of passage, and the he point, place of gathering. The circulation of the 27 energies also passes by these points.
The energy and blood circulating outside the channels at the level of the skin and flesh, originating from the great luo (dai luo: longitudinal luo and tendinomuscular channels) of the 5 organs, flows down to the ying and shu points to unite with the blood and energy circulating within the channels at the level of the elbow and knee, that is to say, at the he points. Such is the circulatory process of the energy and blood of the organs/bowels and of the jingmai at the level of the shu-antique points. (Figure 4).
II - Ma Shi comments :
“The jing, ying, shu, jing and he points are the sites of passage of the energy of the organs/bowels and of the jingluo (principal and secondary channels).
The 5 organs are heart, lung, spleen, liver and kidney. They each have their shu-antique points: jing, ying, shu, jing and he, that is, 5 X 5 = 25 shu-antique.
To the 5 organs and 6 bowels, one adds the xin bao luo (XB), totaling 12 principal channels (jing). Each channel has its own luo, making 12 points, to which one adds Changqiang (GV 1) of the Dumai, Jiuwei (CV 15) of the renmai and Dabao (Sp 21) of the spleen, totaling
15 luo points. 39.
The study of these luo is found in Chapter 10 (“Channels-Vessels”) of this classic. But the Nanjing does not consider Changqiang (GV 1), Jiuwei (CV 15) and Dabao (Sp 21) to be luo and speaks of yangqiao and yinqiao, which are not adapted to the text of the Lingshu.
According to Chapter 18 (“Energetic Aspects of the Pulses of Man in Good Health”) of the Suwen, the stomach has 2 luo points, Fenglong (St 40) and Xie Li (internal luo vessel of the
stomach), and the spleen also has 2 luo points, Gongsun (Sp 4) and Dabao (Sp 21, external vessel), thereby showing the importance of the generatory system (spleen-stomach) of blood and energy. But if one only considers the external circulation of the luomai, there are 15. 38...
The energy of the 12 channels and that of the the 15 luo circulating in the external part of the body form one circulatory system of 27 energies. The place where the energy begins its circulation is called the jing point, implying the sense of a source (from a mountain), such as the point Shaoshang (Lu 11) of the lung channel.
