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Huangdi Neijing · The Yellow Emperor’s Inner Canon
Suwen 28 · General Account of Deficiency and Repletion
Read in English. Switch to Original for word notes, or select text to ask a question.
The Yellow Emperor asked: “What are called deficiency and repletion?”
Qi Bo replied: “Flourishing harmful qi is repletion; the loss of essential qi is deficiency.”
The Emperor asked: “How do deficiency and repletion appear?”
Qi Bo said: “Qi deficiency is Lung deficiency. Counterflow qi means cold feet. Outside its corresponding season there is survival; in that season there is death. The other zang organs follow the same principle.”
The Emperor asked: “What is called doubled repletion?”
Qi Bo said: “Doubled repletion means a great heat illness, with hot qi and a full pulse. This is called doubled repletion.”
The Emperor asked: “What if both channels and networks are replete, and how is this treated?”
Qi Bo said: “When channels and networks are both replete, the cun pulse is urgent and the chi relaxed. Both should be treated.
Thus slipperiness follows the proper course and roughness opposes it. Deficiency and repletion begin within their respective kinds. If the five zang organs, bone and flesh are smooth and freely functioning, life can endure.”
The Emperor asked: “What if network qi is insufficient while channel qi is excessive?”
Qi Bo said: “When network qi is insufficient and channel qi excessive, the pulse opening is hot and the chi region cold. In autumn and winter this is contrary; in spring and summer it follows the proper course. Treat what governs the illness.”
The Emperor asked: “What if channels are deficient and networks full?”
Qi Bo said: “When channels are deficient and networks full, the chi region is hot and full, while the pulse opening is cold and rough. This means death in spring and summer and survival in autumn and winter.”
The Emperor asked: “How is this treated?”
Qi Bo said: “When networks are full and channels deficient, apply moxa to yin and needle yang. When channels are full and networks deficient, needle yin and apply moxa to yang.”
The Emperor asked: “What is called doubled deficiency?”
Qi Bo said: “Deficiency of pulse qi above together with deficiency at chi is called doubled deficiency.”
The Emperor asked: “How is it treated?”
Qi Bo said: “Qi deficiency means speech lacks constancy. Chi deficiency means walking is fearful and unsteady. Pulse deficiency means it does not show the image of yin. In such cases slipperiness means survival and roughness death.”
The Emperor asked: “What if cold qi suddenly rises and the pulse is full and replete?”
Qi Bo said: “Replete and slippery means survival; replete and contrary means death.”
The Emperor asked: “What if the pulse is replete and full, hands and feet cold, and the head hot?”
Qi Bo said: “In spring and autumn there is survival; in winter and summer death. A floating, rough pulse, with bodily heat accompanying the roughness, means death.”
The Emperor asked: “What if the entire bodily form is full?”
Qi Bo said: “When the entire form is full, the pulse is urgent, large and firm, and the chi region rough and unresponsive. In this condition, following the proper course means survival; opposing it means death.”
The Emperor asked: “What is meant by survival through following and death through opposing?”
Qi Bo said: “Following means warm hands and feet. Opposing means cold hands and feet.”
The Emperor asked: “What of a nursing infant with heat illness and a suspended, small pulse?”
Qi Bo said: “Warm hands and feet mean survival; cold means death.”
The Emperor asked: “What pulse occurs when a nursing infant is struck by wind and heat, pants noisily and raises the shoulders to breathe?”
Qi Bo said: “With noisy panting and shoulder breathing, the pulse is replete and large. A relaxed pulse means survival; an urgent one death.”
The Emperor asked: “What of intestinal flux with blood in the stool?”
Qi Bo said: “Bodily heat means death; cold means survival.”
The Emperor asked: “What of intestinal flux discharging white foam?”
Qi Bo said: “A sinking pulse means survival; a floating pulse death.”
The Emperor asked: “What of intestinal flux discharging pus and blood?”
Qi Bo said: “A suspended pulse that breaks off means death; a slippery, large pulse means survival.”
The Emperor asked: “What of intestinal flux when the body is not hot and the pulse is not suspended and broken off?”
Qi Bo said: “Slippery and large is called survival; suspended and rough is called death. Assign the period according to the zang organ.”
The Emperor asked: “What of dian illness?”
Qi Bo said: “If the pulse beats large and slippery, the illness ends of itself after a long time. If the pulse is small, firm and urgent, death follows and treatment is impossible.”
The Emperor asked: “What of deficiency and repletion in the pulse of dian illness?”
Qi Bo said: “Deficiency can be treated; repletion means death.”
The Emperor asked: “What of deficiency and repletion in wasting-heat illness?”
Qi Bo said: “With a replete, large pulse, even longstanding illness can be treated. With a suspended, small and firm pulse, longstanding illness cannot be treated.”
The Emperor asked: “How are the measures of bodily form, bone, vessels and sinews known?”
The Emperor said: “In spring, promptly treat channels and networks; in summer, channel transport points; in autumn, the six fu organs; in winter, closure prevails. During closure use medicinals and few needles or stone lancets. Few needles and lancets does not refer to abscesses and deep sores: these must not be delayed even briefly.
When an abscess has no clear location, does not answer the pressing hand, and comes and goes, make three punctures beside Hand Taiyin, and two each at the neck’s ying vessels. For an axillary abscess with great heat, needle Foot Shaoyang five times. If heat persists, needle the Hand Heart Master three times and Hand Taiyin channels and networks at the meetings of the great bones, three each.
For sudden abscess with contracted sinews and pain following the divisions, with po-sweat unceasing and insufficient bladder qi, treatment is at channel transport points. When the abdomen suddenly becomes full and pressing does not reduce it, treat Hand Taiyang channels and networks, described here as Stomach’s gathering site. At Shaoyin transport sites three cun from the spinal vertebrae, use five needlings beside them with a round-sharp needle.
For sudden vomiting and diarrhea, needle beside the transport points five times, and Foot Yangming and the region beside and above it three times. For convulsive fright, needle the vessel five times; needle Hand Taiyin five each, the Taiyang channel five, beside Hand Shaoyin channels and networks once, and Foot Yangming once; five cun above the ankle insert three needles.
Reading note: The source’s locations, counts and sequence are retained without assigning standardized modern point numbers or needling depths. Po-sweat retains the supplied 魄汗 term; 胞 is rendered bladder in this context.”
In treating wasting heat, collapse as though struck, one-sided withering, wilting weakness and counterflow, or fullness of qi with sudden contrary rising: in well-fed people of rank these are illnesses of rich grains and fine food. Blockage and closure cutting off communication between above and below are illness from sudden grief. Sudden counterflow with deafness and one-sided obstruction arises from an abrupt inward clash of qi. Illness from being struck by wind that follows neither an internal nor external course leaves a wasting condition lodged within. Lameness of the sole is illness from cold, wind and dampness.
Reading note: The obscure supplied 瘦留著 is rendered as a wasting condition that remains lodged; it is not assigned a modern diagnosis.
The Yellow Emperor said: “Jaundice with sudden pain, dian illness, counterflow and frenzy arise from prolonged contrary movement. Disharmony of the five zang organs arises from closure of the six fu organs. Headache, ringing ears and obstruction of the nine openings arise from the intestines and Stomach.”
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