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Huangdi Neijing · The Yellow Emperor’s Inner Canon
Lingshu 9 · End and Beginning
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“The Way of needling is completed in end and beginning. Know these clearly, take the five zang as the ordering thread, and yin and yang are determined. Yin governs zang; yang governs fu. Yang receives qi at the four extremities, yin at the five zang. Draining therefore meets it; supplementation follows it. Know meeting and following and qi can be harmonized.
“The method must comprehend yin and yang: five zang are yin, six fu yang. Transmit this to later generations with a blood covenant. Reverence brings flourishing; carelessness brings ruin. Acting privately without the Way brings early calamity. Carefully uphold heaven’s Way. Let me explain end and beginning.”
“End and beginning take channel vessels as the ordering thread. Hold the pulse opening and Renying to know excess and insufficiency, balance and imbalance in yin and yang. Heaven’s Way is complete. A balanced person is not ill: pulse opening and Renying answer the four seasons, above and below respond and come and go together, the six channel pulses do not bind or stir abnormally, and root and tip keep mutual command of cold and warmth. Form, flesh, blood and qi correspond. This is the balanced person.
“In scant qi, pulse opening and Renying are both scant and do not accord with cun and chi. Yin and yang are insufficient together. Supplementing yang exhausts yin; draining yin sheds yang. Such a person may be supported with sweet medicinals but not given extreme preparations. Do not apply moxibustion. If illness does not cease and draining is then used, the five zang qi break down.”
“Renying at the first degree of abundance indicates Foot Shaoyang; with agitation, Hand Shaoyang.
“At the second degree, Foot Taiyang; with agitation, Hand Taiyang.
“At the third degree, Foot Yangming; with agitation, Hand Yangming.
“At the fourth degree, large and rapid as well, it is named overflowing yang. Overflowing yang is external blockage.”
The degrees retain the source’s first/second/third/fourth terminology without recalculating relative pulse ratios.
“The pulse opening at the first degree of abundance indicates Foot Jueyin; with agitation, the Hand Heart Ruler.
“At the second degree, Foot Shaoyin; with agitation, Hand Shaoyin.
“At the third degree, Foot Taiyin; with agitation, Hand Taiyin.
“At the fourth degree, large and rapid as well, it is named overflowing yin. Overflowing yin is internal closure; if it does not pass, death follows and it cannot be treated.”
“When Renying and the Taiyin pulse opening are both abundant fourfold or more, it is named closure and blockage. The text assigns this a shortened term.”
“At Renying’s first degree, drain Foot Shaoyang and supplement Foot Jueyin: two drainings and one supplementation, addressed once daily. Palpate and verify, address above sparingly, and stop when qi harmonizes.
“At its second degree, drain Foot Taiyang and supplement Foot Shaoyin: two drainings and one supplementation, once every two days. Palpate and verify, address above sparingly, and stop when qi harmonizes.
“At its third degree, drain Foot Yangming and supplement Foot Taiyin: two drainings and one supplementation, twice daily. Palpate and verify, address above sparingly, and stop when qi harmonizes.”
The compressed sparing/upper-addressing phrase is retained at its stated level, without added points or depths. Counts and intervals belong to the source.
“At the pulse opening’s first degree, drain Foot Jueyin and supplement Foot Shaoyang: two supplementations and one draining, once daily. Palpate and verify, address above sparingly, and stop when qi harmonizes.
“At its second degree, drain Foot Shaoyin and supplement Foot Taiyang: two supplementations and one draining, once every two days. Palpate and verify, address above sparingly, and stop when qi harmonizes.
“At its third degree, drain Foot Taiyin and supplement Foot Yangming: two supplementations and one draining, twice daily. Palpate and verify, address above sparingly, and stop when qi harmonizes.”
“Twice-daily addressing is allowed because Yangming governs the Stomach and is very rich in grain qi. If Renying and the pulse opening are both abundant threefold or more, yin and yang are named overflowing together. Unless opened, the blood vessels close, qi has nowhere to move and overflows within, injuring the five zang. Applying moxibustion then transforms it into another illness.”
The threefold threshold is retained, distinct from the preceding fourfold closure-and-blockage statement.
“In needling, stop when qi is regulated. Supplementing yin and draining yang makes voice and qi clearer and ears and eyes keen. Opposing this stops blood and qi from moving. The effect of qi arriving means that draining increases emptiness: the pulse remains as large as before but is no longer firm. If firmness remains, whatever is said about its former state, illness has not gone. Supplementation increases repletion: the pulse remains as large but grows firmer. If unchanged and not firm, even if relief is reported, illness has not gone.
“Supplementation therefore makes replete and draining makes empty. Though pain does not leave with the needle, illness must decline and depart. First understand the illnesses produced by the twelve channels; only then may end and beginning be transmitted. Where yin and yang do not shift into each other and emptiness and repletion do not overwhelm each other, address their own channel.
“In needling, three insertions bring grain qi. Harmful influences combine recklessly; yin and yang exchange residence, opposing and following reverse, sinking and floating occupy different places, the four seasons fail to accord, and detained excess awaits the needle to depart. The first insertion releases yang harmful influence, the second yin harmful influence, the third brings grain qi. Stop when grain qi arrives. This arrival means supplementation has made replete and draining empty; thus it is known. If harmful qi alone leaves, yin and yang may not yet be regulated, yet the illness is known to improve. Hence: supplementation makes replete and draining empty; though pain does not leave with the needle, illness must decline and depart.”
“If yin is abundant and yang declines, first supplement yang, then drain yin to harmonize. If yin is empty and yang abundant, first supplement yin, then drain yang. Examine the emptiness or repletion of the three moving vessels in the great-toe region. Draining emptiness is doubled emptiness and worsens illness. Press with a finger: a replete, swift movement is promptly drained; an empty, slow one supplemented. Reversing this worsens illness. Yangming moves above, Jueyin in the middle and Shaoyin below.
“Chest transporting points address the chest; back points the back. For emptiness of shoulder and upper arm, address above. For a doubled tongue, the text uses the sword needle at the tongue pillar. A hand that bends but does not extend has sinew illness; one that extends but does not bend has bone illness. Keep to bone for bone, sinew for sinew.
“In the supplementation rule, address a replete side deeply, pressing the puncture sparingly to let harmful qi emerge fully. Address an empty side shallowly to nourish its vessel, pressing promptly so harmful qi cannot enter. Harmful qi arrives tense and swift; grain qi slow and harmonious.
“For a replete vessel, needle deeply to discharge qi. For an empty vessel, shallowly, keeping essence and qi from emerging, nourishing its vessel and releasing harmful qi alone.”
The great-toe assignment and the abrupt supplementation/repletion wording are retained rather than silently regularized. No unmentioned anatomical landmark is supplied for the tongue pillar.
“The pulses of painful illness are all replete. Thus Hand Taiyin and Yangming govern above the waist; Foot Taiyin and Yangming below. For illness above, address below; for illness below, above. For head illness, address the foot; for lower-back illness, the knee hollow. Illness arising in the head makes the head heavy; arising in the hand makes the arm heavy; arising in the foot makes the foot heavy. Treatment first needles where illness arose.”
“Spring qi is in the hair, summer qi in the skin, autumn qi between flesh divisions and winter qi in sinews and bones. Needling follows the appropriate seasonal measure. Thus for a fleshy person use autumn and winter’s measure; for a lean person spring and summer’s.”
“Painful illness is yin; pain that cannot be reached by pressing is yin and is needled deeply. Illness above is yang; below, yin. Itching is yang and is needled shallowly. If illness begins in yin, treat yin first and yang afterward. If it begins in yang, treat yang first and yin afterward.”
“For heat counterflow, retaining the needle turns it to cold; for cold counterflow, retention turns it to heat. Heat counterflow uses two yin and one yang; cold counterflow two yang and one yin. Two yin means two needlings of yin; one yang means one needling of yang.”
“In longstanding illness, harmful qi has entered deeply. The text describes deep insertion and long retention, repeated on alternate days. First regulate left and right and remove blood from its vessels. The Way of needling is complete.”
“In every needling, examine form and qi. If flesh is not yet wasted but qi is scant and the pulse agitated, with agitated counterflow, use crossing needling. Scattered qi can be gathered; concentrated qi can be spread. Remain deep in a quiet place and observe spirit’s coming and going. Close doors and windows so hun and po do not scatter. Concentrate attention into one spirit and the divisions of essence and qi. Hear no human voices, gathering essence and unifying spirit. Let the will attend to the needle; retain shallowly, subtly and superficially, shifting spirit, and stop when qi arrives. Male within, female outside: firmly resist without letting out, carefully guard without letting in. This is called obtaining qi.”
The compressed male/female and in/out clauses are retained without assigning an unmentioned bodily action or modern technique.
“Do not needle immediately after sexual activity; do not engage in it immediately after needling. Do not needle after drunkenness or become drunk after needling. Do not needle just after anger or become angry afterward. Do not needle just after exertion or exert afterward. Do not needle when full or overeat afterward. Do not needle when hungry or remain hungry afterward. Do not needle when thirsty or remain thirsty afterward. After great fright or fear, first settle qi.
“One arriving by carriage should lie down and rest for the time of a meal before needling. One arriving from walking should sit and rest for the time of walking ten li. These are called the twelve prohibitions: the pulse is disordered and qi scatters or counterflows, while nutritive, defensive and channel qi are out of sequence. Needling then sends yang illness into yin and brings yin illness outward as yang; harmful qi arises again. The crude practitioner fails to observe this: it is called attacking the body. Bodily form overflows and scatters, brain and marrow are consumed, fluids fail to transform and the five flavors are lost. This is called loss of qi.”
The source’s twelve-count, listed pairings and relative rest measures are retained without recalculation or conversion into clock time.
“At the Taiyang vessel’s end, eyes turn upward, the body bends backward and spasms occur. Color is white; skin separation is followed by terminal sweat, and with that sweat comes the end.
“At Shaoyang’s end there is deafness, all joints become loose and eye connections are cut off. Once they are cut off, the text assigns death in a day and a half, with blue-green and white color.
“At Yangming’s end, mouth and eyes move, fright is frequent, speech reckless and color yellow. Its upper and lower channels are abundant but do not move, and the end follows.
“At Shaoyin’s end, the face is black, teeth long and dirty, the abdomen distended and blocked, and above and below fail to pass.
“At Jueyin’s end, heat is within, the throat dry, urination frequent and the Heart vexed. Severe cases bring a curled tongue and testicles drawn upward.
“At Taiyin’s end, the abdomen is distended and closed, breathing impossible, qi belches and vomiting is frequent. Vomiting brings counterflow and red face. Without counterflow, above and below fail to pass; then the face blackens and skin and hair scorch, and the end follows.”
The channel endings, repeated eye-connection clause and stated time remain the source’s prognostic account, not modern clinical prediction.
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