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Huangdi Neijing · The Yellow Emperor’s Inner Canon
Suwen 62 · Regulating the Channels
Read in English. Switch to Original for word notes, or select text to ask a question.
The Yellow Emperor asked: “The Needling Methods says to drain excess and supplement insufficiency. What is excess, and what insufficiency?”
Qi Bo replied: “There are five excesses and also five insufficiencies. Which does the Emperor wish to ask about?”
The Emperor said: “I wish to hear them all.”
Qi Bo said: “Spirit has excess and insufficiency; qi excess and insufficiency; blood excess and insufficiency; form excess and insufficiency; resolve excess and insufficiency. In these ten conditions, their qi is unequal.”
The Emperor asked: “People have essence, qi and fluids, four limbs and nine openings, five zang organs and sixteen regions, and three hundred sixty-five joints. From these arise the hundred illnesses, all with deficiency and repletion. You now speak of five excesses and five insufficiencies. How do they arise?”
Qi Bo said: “All arise from the five zang organs. Heart stores spirit; Lung qi; Liver blood; Spleen flesh; Kidney resolve. These complete the form. Resolve and intention communicate within and join bone and marrow, completing bodily form and the five zang organs. The organs’ pathways all emerge through channel passages to move blood and qi. Disharmonious blood and qi transform and produce the hundred illnesses. Thus guard the channel passages.”
The Emperor asked: “What is spirit’s excess or insufficiency like?”
Qi Bo said: “Excess spirit brings unceasing laughter; insufficient spirit grief. Before blood and qi have gathered, the five zang organs are settled and harmful influence lodges in bodily form. Shivering begins at the fine hairs, without entry into channels and networks. Thus it is called subtle disturbance of spirit.”
The Emperor asked: “How are supplementation and draining applied?”
Qi Bo said: “For excess spirit, drain blood from the small networks. Release blood without deep thrusting or striking the great channels; spiritual qi then becomes balanced. For insufficient spirit, inspect deficient networks, press to bring qi and needle to free them. Do not release blood or discharge qi. Free their channels, and spiritual qi becomes balanced.”
The Emperor asked: “How is the subtle disturbance needled?”
Qi Bo said: “Massage without letting go; place the needle without thrusting. Move qi toward insufficiency, and spiritual qi can recover.”
The Emperor said: “Good. What of excess and insufficiency?”
Qi Bo said: “Excess qi brings panting, cough and upward qi. Insufficiency brings freely passing breath with scant qi. Before blood and qi have gathered, the five zang organs are settled and skin is slightly ill: this is called slight leakage of white qi.”
The Emperor asked: “How are supplementation and draining applied?”
Qi Bo said: “For excess qi, drain its channel passages without injuring the channels, releasing blood or discharging qi. For insufficiency, supplement the channel passages without letting qi escape.
Reading note: The supplied injunction not to discharge qi during draining is retained rather than replaced with a different wording.”
The Emperor asked: “How is the slight disturbance needled?”
Qi Bo said: “Massage without letting go. Bring out the needle and show it, saying, ‘I shall go deep.’ The person must change; essential qi settles by itself. Harmful qi scatters in disorder with no place to rest; qi discharges through the interstices and true qi finds mutual accord.
Reading note: The supplied 適人必革 is rendered broadly as a change in the person, without inventing a specific physiological reaction.”
The Emperor said: “Good. What of excess and insufficiency of blood?”
Qi Bo said: “Excess blood brings anger; insufficient blood fear. Before blood and qi have gathered, the five zang organs are settled. Water overflowing in the fine networks leaves retained blood in the channels.”
The Emperor asked: “How are supplementation and draining applied?”
Qi Bo said: “For excess blood, drain the abundant channels and release blood. For insufficiency, inspect the deficient channel and insert the needle into its vessel. Retain it and observe; when the vessel enlarges, withdraw quickly without letting blood escape.”
The Emperor asked: “How is retained blood needled?”
Qi Bo said: “Inspect the blood networks and needle to release their blood. Do not allow bad blood to enter the channels and establish the illness.”
The Emperor said: “Good. What of excess and insufficiency of form?”
Qi Bo said: “Excess form brings abdominal distention and difficult passage of stool and urine. Insufficient form leaves the four limbs unusable. Before blood and qi have gathered, the five zang organs are settled and flesh twitches: this is called slight Wind.”
The Emperor asked: “How are supplementation and draining applied?”
Qi Bo said: “For excess form, drain its yang channels. For insufficiency, supplement its yang networks.”
The Emperor asked: “How is the slight disturbance needled?”
Qi Bo said: “Treat between the divisions of flesh without striking channels or injuring networks. Defensive qi recovers and harmful qi is exhausted.”
The Emperor said: “Good. What of excess and insufficiency of resolve?”
Qi Bo said: “Excess resolve brings abdominal distention and flux of undigested food; insufficiency counterflow. Before blood and qi have gathered, the five zang organs are settled and the bone joints stir.”
The Emperor asked: “How are supplementation and draining applied?”
Qi Bo said: “For excess resolve, drain the blood-filled ran sinew site. For insufficiency, supplement Fuliu.
Reading note: Ran sinew retains the supplied 然筋 designation without silently replacing it with a different named modern point.”
The Emperor asked: “How is it needled before they have gathered?”
Qi Bo said: “Treat it at once without striking its channel. The site of harmful influence can then immediately be emptied.”
The Emperor said: “Good. I have heard the forms of deficiency and repletion but do not know how they arise.”
Qi Bo said: “Qi and blood gather; yin and yang lean against one another. Qi is disordered in the defensive region and blood runs contrary in the channels. Blood and qi dwell apart: one replete and one deficient.
Blood gathering in yin and qi in yang produces startlement and frenzy. Blood gathering in yang and qi in yin produces internal heat. Blood gathering above and qi below brings vexation and distress at Heart and frequent anger. Blood gathering below and qi above brings confusion and frequent forgetfulness.”
The Emperor asked: “When blood gathers in yin and qi in yang and they dwell apart, which is replete and which deficient?”
Qi Bo said: “Blood and qi like warmth and dislike cold. Cold roughens them so they cannot flow; warmth dissolves the constraint and moves them on. Thus where qi gathers, blood is deficient; where blood gathers, qi is deficient.”
The Emperor asked: “People possess blood and qi. You say gathered blood is deficiency and gathered qi deficiency. Is there no repletion?”
Qi Bo said: “Presence is repletion; absence deficiency. Where qi gathers there is no blood; where blood gathers no qi. Blood and qi now fail to meet, hence deficiency. If networks and fine branch vessels both convey to the channels and blood and qi gather together, there is repletion.
If blood and qi together rush above, there is great counterflow and sudden deathlike collapse. If qi returns, the person lives; if it does not, death follows.”
The Emperor asked: “By what route does repletion arrive, and by what route does deficiency leave? I wish to hear the essentials and their reason.”
Qi Bo said: “Yin and yang both have transport meetings. Yang pours into yin; full yin moves outward. Yin and yang are evenly balanced and fill the form. The nine examinations are as one: a normal person.
Harmful influence may arise in yin or yang. Arising in yang, it is acquired from wind, rain, cold and summer heat. Arising in yin, it is acquired from food, drink, dwelling, yin and yang relations, joy and anger.”
The Emperor asked: “How do wind and rain injure people?”
Qi Bo said: “Wind and rain first lodge in skin, then transmit into fine branch vessels. When those fill, they transmit into networks; full networks convey into great channels. Blood, qi and harmful influence lodge together between the divided interstices. The vessels are firm and large, hence repletion. Repletion means firmness and fullness outside that cannot bear pressure; pressing causes pain.”
The Emperor asked: “How do cold and dampness injure people?”
Qi Bo said: “When cold and damp strike, skin does not hold, flesh becomes firm and tight, nutritive blood roughens and defensive qi leaves: hence deficiency. Deficiency brings constrained, short qi that is insufficient. Pressure brings enough qi to warm it, so relief comes without pain.
Reading note: The obscure 聶辟 is rendered broadly as constrained and short, without assigning it a modern respiratory diagnosis.”
The Emperor said: “Good. How does yin produce repletion?”
Qi Bo said: “Unregulated joy and anger make yin qi rise contrary. This empties below; yang qi runs toward that deficiency. Thus it is called repletion.”
The Emperor asked: “How does yin produce deficiency?”
Qi Bo said: “Joy makes qi descend; grief dissipates it. Dissipation leaves the vessels empty and deficient. Cold food and drink then fill them with steaming cold qi, roughening blood and driving qi away. Thus deficiency.
Reading note: The supplied joy/descent relationship is kept, alongside other chapters’ descriptions of joy relaxing qi.”
The Emperor said: “I have heard the canon’s statements: deficient yang produces external cold; deficient yin internal heat; abundant yang external heat; abundant yin internal cold. I do not know why these occur.”
Qi Bo said: “Yang receives qi from the upper burner to warm skin and the divisions of flesh. When cold qi is outside, the upper burner becomes obstructed. Cold qi alone remains outside, hence shivering cold.”
The Emperor asked: “How does deficient yin generate internal heat?”
Qi Bo said: “Toil and exhaustion reduce bodily form and qi. Grain qi is not abundant; the upper burner fails to move and the lower Stomach cavity is obstructed. Stomach qi becomes hot, and heat steams within the chest: hence internal heat.”
The Emperor asked: “How does abundant yang generate external heat?”
Qi Bo said: “The upper burner does not pass freely. Skin becomes dense, interstices close and the dark receptacles are obstructed. Defensive qi cannot discharge outward: hence external heat.”
The Emperor asked: “How does abundant yin generate internal cold?”
Qi Bo said: “Counterflow qi rises. Cold qi accumulates in the chest without draining; warmth leaves and cold alone remains. Blood congeals and roughens, blocking the vessels. Their pulse is abundant, large and rough: hence internal cold.”
The Emperor asked: “Yin and yang have combined, blood and qi gathered, and the illness’s form is established. How is it needled?”
Qi Bo said: “Treat through the channel passages. Take blood from the nutritive region and qi from the defensive region. Use the bodily form as the basis, following the four seasons in amount, height and depth.”
The Emperor asked: “Blood and qi have gathered, illness has taken form and yin and yang lean against one another. How are supplementation and draining applied?”
Qi Bo said: “To drain repletion, insert when qi is abundant. Needle and qi enter together, opening its gate and freeing its doorway. Needle and qi leave together; essential qi is not injured and harmful qi descends. Leave the outer gate unclosed to discharge the illness. Enlarge the route by movement, as though clearing a path. This is called great draining. Withdraw urgently and the great harmful qi retreats.”
The Emperor asked: “How is deficiency supplemented?”
Qi Bo said: “Hold the needle without setting it aside and settle intent. Wait for exhalation to insert: qi leaves while the needle enters. Close around the needle opening on all four sides so essence cannot leave. When fullness arrives, withdraw quickly: qi enters while the needle leaves. Warmth cannot return outward. Close its gate; harmful qi disperses and essential qi is preserved.
Stir qi and await its time. Do not lose near qi; distant qi then comes. This is called pursuing it.”
The Emperor asked: “You say the ten conditions of deficiency and repletion arise from the five zang organs, which have only five pulses. Yet all twelve channel vessels produce illness. You speak only of the five organs. All twelve channels network with the three hundred sixty-five joints; illness in a joint must involve a channel. Channel illnesses all have deficiency and repletion. How are these joined?”
Qi Bo said: “The five zang organs obtain the six fu organs as their exterior–interior partners. Channels, networks, limbs and joints each develop deficiency and repletion. Regulate according to where the illness resides.
Illness in vessels: regulate blood. In blood: regulate networks. In qi: regulate the defensive region. In flesh: regulate flesh divisions. In sinews: regulate sinews. In bone: regulate bone. Apply heated needles and forceful needling below, and to urgent conditions. For bone illness, use fire-heated needles and medicinal warm applications.
When the painful site is unknown, the two qiao vessels take priority. With bodily pain but no illness in the nine examinations, use miu needling. With pain on the left but a diseased right pulse, use ju needling. Carefully examine the nine examinations: then the Way of needling is complete.
Reading note: Miu and ju retain the source’s distinct 繆刺 and 巨刺 methods. The compressed heated-needle clause is preserved without inventing a location or insertion depth.”
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