黄帝问于岐伯曰。余闻针道于夫子。众多毕悉矣。夫子之道。应若失而据未有坚然者也。夫子之
问学熟乎。将审察于物而心生之乎。
此篇论人之形体浓薄。血气清浊。以应天地之道。逆顺而行者也。夫子之道应若失者。谓道之
幽远难寻。坚、确也。察于物者。即物穷理。心生之者。豁然贯通也。盖圣人之道。通乎天地。而
合于事物之常。杨氏曰。失坚者。即颜子所谓钻之弥坚。瞻之在前。忽焉在后之意。
岐伯曰。圣人之为道者。上合于天。下合于地。中合于人事。必有明法。以起度数。法式检押。
乃后可传焉。故匠人不能释尺寸而意短长。废绳墨而起平水也。工人不能置规而为圆。去矩而为方。
知用此者。固自然之物。易用之教。逆顺之常也。黄帝曰。愿闻自然奈何。岐伯曰。临深决水。不用
工力。而水可竭也。循掘决冲。而经可通也。此言气之滑涩。血之清浊。行之逆顺也。
伯言天地之道。出于自然。不待勉强。虽幽远难明。然不出乎规矩方圆之外。临深决水者。决之
去也。循掘决冲者。导之来也。此逆顺之行也。杨氏曰。规矩方圆。天地之象也。逆顺者。地气左迁。
天道右旋也。不用工力者。造化之自然也。
黄帝曰。愿闻人之白黑肥瘦小长。各有数乎。岐伯曰。年质壮大。血气充盈。肤革坚固。因加
以邪。刺此者。深而留之。此肥人也。广肩腋。项肉薄。皮浓而黑色。唇临临然。其血黑以浊。其气
涩以迟。其为人也。贪于取与。刺此者。深而留之。多益其数也。
此论形体之太过也。广肩腋者。广阔于四旁也。项乃太阳之所主。项肉薄而皮浓黑色者。太阳之
水气盛也。唇乃脾土之外候。临临然者。土气浓大也。黑者水之色。血黑以浊者。精水之重浊也。气
涩以迟者。肌肉浓而气道滞也。夫太过则能与。不及则贪取。贪于取与者。不得中和之道。过犹不
及也。杨元如曰。前篇论五脏之气。应土基浓薄。气色清粗。此篇论形之肥瘦。血之清浊。以应
太过不及。盖皮肉脉筋骨。五脏之外合也。
朱济公曰。五运主中。六气主外。人秉天地之运气而生。故多有太过不及。
黄帝曰。刺瘦人奈何。岐伯曰。瘦人者皮薄色少。肉廉廉然。薄唇轻言。其血清气滑。易脱于
气。易损于血。刺此者。浅而疾之。
此论形体之不及也。皮薄色少。秉天气之不足也。廉廉。瘦洁貌。肉廉廉然。薄唇轻言。秉地
气之不足也。血清者。水清浅也。气滑者。肌肉薄而气道滑利也。莫仲超曰。音主长夏。土气薄。
故言轻。朱济公曰。气道之滑涩。由肌肉之浓薄。应天气之行于地中。
黄帝曰。刺常人奈何。岐伯曰。视其白黑。各为调之。其端正敦浓者。其血气和调。刺此者。
无失常数也。
此论平人之和调也。黑白者。水天之色也。端正敦浓者。坤之德也。此得天地平和之气。故其
血气和调也。常数者。天地之常数也。盖以人应天地之气。而针合天地人之数也。
黄帝曰。刺壮士真骨者奈何。岐伯曰。刺壮士真骨坚。肉缓。节监监然。此人重则气涩血浊。
刺此者深而留之。多益其数。劲则气滑血清。刺此者。浅而疾之。
此言年壮之士。得天真之完固也。先天之真元。藏于肾而肾主骨。天真完固。而后骨肉充满也。
真骨坚。肉缓。节监监者。筋骨和而肌肉充也。监监者。卓立而不倚也。其人重浊。则气涩血浊。其
人轻劲。则气滑血清。盖元真者。乃混然之气。已生之后。而有轻重高下之分焉。深而留之。浅而疾
之。导其气出入于外内也。
黄帝曰。刺婴儿奈何。岐伯曰。婴儿者。其肉脆。血少气弱。刺此者以毫针。浅刺而疾发针。
日再可也。
此言婴儿未得天真充盛。其肉脆而血少气弱也。襁褓乳养曰婴。盖男子八岁。女子七岁。肾气
始盛。齿更发长。男子四八。女子四七。则筋骨隆盛。肌肉满壮。盖形肉血气。虽藉后天水谷之所
资生。然本于先天之生原也。日再者。导阴阳血气之生长。
黄帝曰。临深决水奈何。岐伯曰。血清气浊。疾泻之。则气竭焉。黄帝曰。循掘决冲奈何。岐伯
曰。血浊气涩。疾泻之。则经可通也。
清浊者。天地之气也。临深决水。循掘决冲。行之逆顺也。血气逆顺而行。应天地之旋转也。
按、此篇论形肉之浓薄坚脆。血气之多少清浊。应太过不及之气。故用针之浅深疾徐。刺法之多少
补泻。皆以针合人而导之和平。是以一篇之中。并无邪病二字。若以泻邪论之。去经义远矣。
黄帝曰。脉行之逆顺奈何。岐伯曰。手之三阴。从脏走手。手之三阳。从手走头。足之三阳。
从头走足。足之三阴。从足走腹。
此言手足阴阳之脉。上下外内。逆顺而行。应地之经水也。
黄帝曰。少阴之脉独下行何也。岐伯曰。不然。夫冲脉者。五脏六腑之海也。五脏六腑皆禀焉。
其上者。出于颃颡。渗诸阳。灌诸精。其下者。注少阴之大络。出于气街。循阴股内廉。入 中。伏行
骨内。下至内踝之后。属而别。其下者。并于少阴之经。渗三阴。其前者。伏行出跗。属下。循跗
入大趾间。渗诸络而温肌肉。故别络结。则跗上不动。不动则厥。厥则寒矣。黄帝曰。何以明之。岐
伯曰。以言导之。切而验之。其非必动。然后乃可明逆顺之行也。黄帝曰。窘乎哉。圣人之为道也。
明乎日月。微于毫厘。其非夫子。孰能道之也。
此言血气行于脉外。以应天之道也。夫司天在上。在泉在下。水天之气。上下相通。应人之血
气。充肤热肉。淡渗皮毛。而肌肉充满。若怯然少气者。则水道不行。而形气消索矣。夫冲脉者。
五脏六腑之海也。五脏六腑之气。皆禀于冲脉而行。其上者。出于颃颡。渗诸阳。灌诸阴。其下者
注少阴之大络。下出于气街。此五脏六腑之血气。皆从冲脉而渗灌于脉外皮肤之间。应水随气而运
行于天表也。夫少阴主先天之水火。水火者精气也。冲脉并少阴之经。渗三阴。循跗入大趾间。渗诸
络而温肌肉。是少阴之精气。又从冲脉而营运出入于经脉皮肤之外内者也。故别络结。则少阴之
气不能行于跗上。而跗上不动矣。不动者。乃少阴之气厥于内。故
厥则寒矣。此气血结于脉内。而不能通于脉外也。故当导之。以言导气之外出也。验之以脉。知精血
之行也。其非跗上不动。然后乃可明逆顺之行。逆顺之行者。少阴之精气。渗灌于肤表。而复营运
于脉中。应司天在泉之气。绕地环转。而复通贯于地中。明乎日月。微于毫厘者。言圣人之道。如
日月丽天。循度环转。无有毫厘差失。故曰圣人之为道者。上合于天。下合于地。中合于人事。必
有明法。以起度数。法式检押。乃后可传焉。
杨元如曰。五脏六腑。应五运之在中。五运者。神机之出入也。皮肤经脉。应六气之在外。六气
者。左右上下。环转升降者也。五脏六腑之气。禀冲脉而营运于肤表。应地气之出于外也。莫仲超
曰。所谓冲脉者。顺行逆冲于经脉皮肤之外内。充于形身。无往不到。故曰逆顺之行。盖经脉之血气
顺行。则皮肤之气血逆转。所以应天地营运之道也。禀于五脏六腑者。即水谷所生之血气。流溢于中。
由冲脉而布散于皮肤之外。少阴之气血。先天之精气也。并冲脉渗于三阴。而行于脉中循足跗渗足
趾之诸络。而出于脉外。是以阳气起于足五趾之表。阴气起于足五趾之里。盖秉足少阴先天之水火也。
人之形体肥浓。由水谷所生之血气。充肤热肉。淡渗皮毛。其真骨坚。肉缓节监者。秉先天之精气也。
皮肉筋骨。营卫血气。皆本于先天后天生始之血气以资益。而后能筋骨强坚。肌肉丰浓。是以始论
人之肥瘦长短。而末结冲脉少阴之出入焉。
黄帝向岐伯问道：我从夫子那里学习针刺之道，内容已经非常详尽完备了。夫子的道，似乎容易领悟却又难以捉摸，找不到确定的把握之处。请问夫子是凭借熟练的学问，还是通过审察万物而心中豁然贯通的呢？
这一篇论述人的形体厚薄、血气清浊，以顺应天地之道，按照逆顺规律运行的道理。“夫子之道应若失”，是说道的幽深遥远难以寻找；“坚”，指确切、固定。“察于物”，即探究事物的原理；“心生之”，指心中豁然贯通。大概圣人的道，通晓天地，并符合事物的常规。杨氏说：“失坚”，就是颜回所说的“钻之弥坚，瞻之在前，忽焉在后”的意思。
岐伯回答说：圣人建立的道，上合于天，下合于地，中合于人事。必须有明确的法则，以此确立度数、法式和规矩，然后才可以传授。所以工匠不能放弃尺寸标准去随意判断长短，不能废弃墨线去使水平平整；工人不能丢弃圆规去画圆，去掉矩尺去画方。懂得运用这些工具的人，知道这是自然之物，是易于使用的教法，也是逆顺运行的常理。黄帝说：希望听听什么是“自然”。岐伯说：面对深水开闸放水，不需要使用蛮力，水就可以流干；顺着挖掘的地方决口疏通，经络就可以通畅。这是在说明气的滑涩、血的清浊以及运行方向的逆顺。
岐伯谈论天地之道，出于自然，不待勉强。虽然幽深遥远难以明白，但不出乎规矩方圆之外。“临深决水”，是指决口让水流去；“循掘决冲”，是指引导水流来。这就是逆顺的运行。杨氏说：规矩方圆，是天地形象的表现。逆顺，是指地气向左迁移，天道向右旋转。不用工力，是造化的自然。
黄帝说：希望听听人的黑白、肥瘦、高矮，各有定数吗？岐伯说：如果一个人年纪轻壮，血气充盈，皮肤坚固，又加上邪气侵袭，针刺这种人，要深刺并留针。这是针对肥胖的人。他们肩膀宽阔，腋下丰满，颈部肌肉薄弱，皮肤厚实且颜色黑，嘴唇丰厚外翻。他们的血液黑而浑浊，气行涩滞而迟缓。这类人性格贪婪，好取予。针刺这种人，要深刺并留针，增加针刺的次数。
这一段论述形体太过（肥胖）的情况。肩膀宽阔，是指比四周更广阔。颈部是太阳经所主，颈部肌肉薄弱且皮肤厚实黑色的，说明太阳经的水气旺盛。嘴唇是脾土的外在表现，嘴唇丰厚的样子，说明土气浓重。黑色是水之色，血液黑而浑浊，说明精水重浊。气行涩滞迟缓，是因为肌肉浓厚导致气道阻滞。凡是太过就能给予，不及就会贪取。贪婪好取予的人，没有得到中和之道，过与不及是一样的。杨元如说：前一篇论述五脏之气，对应土的浓薄，气色清粗；这一篇论述形体的肥瘦，血的清浊，以对应太过与不及。皮肉脉筋骨，是五脏的外合。朱济公说：五运主管内脏，六气主管体表。人秉承天地的运气而生，所以多有太过或不及。
黄帝说：针刺瘦人该怎么办？岐伯说：瘦人皮肤薄，面色淡，肌肉消瘦，嘴唇薄，说话声音轻。他们的血清气滑，气容易耗脱，血容易受损。针刺这种人，要浅刺并快速出针。
这一段论述形体不及（瘦弱）的情况。皮肤薄、面色淡，是禀受天气不足。廉廉，是瘦洁的样子。肌肉消瘦，嘴唇薄，说话轻，是禀受地气不足。血清，是水液清浅。气滑，是因为肌肉薄而气道滑利。莫仲超说：音主长夏，土气薄，所以说话轻。朱济公说：气道的滑涩，由肌肉的厚薄决定，对应天气在地中的运行。
黄帝说：针刺普通人该怎么办？岐伯说：观察他们的肤色黑白，分别进行调理。那些体态端正敦厚的人，他们的血气和调。针刺这种人，不要违背常规的度数。
这一段论述平和之人的气血调和。黑白，是水天的颜色。端正敦厚，是坤德的体现。这些人得天地平和之气，所以血气和调。常数，是天地的常规度数。大概是以人来对应天地之气，而针刺要符合天地人的数理。
黄帝说：针刺体格强壮、骨骼坚实的人该怎么办？岐伯说：针刺体格强壮、骨骼坚实的人，如果肌肉松弛，关节突出，这种人如果体质沉重，则气涩血浊，针刺要深刺并留针，增加次数；如果体质劲健，则气滑血清，针刺要浅刺并快速出针。
这一段讲年富力壮的人，得天真之气完固。先天的真元藏于肾，肾主骨。天真完固，然后骨肉才充满。骨骼坚实，肌肉松弛，关节突出，说明筋骨和谐而肌肉充盛。“监监”，是卓立而不倚靠的样子。如果人体质重浊，则气涩血浊；如果人体质轻劲，则气滑血清。元气真是浑然一气，出生后才有轻重高下的区别。深刺留针，浅刺疾出，是为了引导气出入于内外。
黄帝说：针刺婴儿该怎么办？岐伯说：婴儿肌肉脆嫩，血少气弱。针刺要用毫针，浅刺并快速出针，一天可以刺两次。
这一段讲婴儿未得天真充盛，肌肉脆嫩，血少气弱。在襁褓中吃奶叫婴。大概男子八岁，女子七岁，肾气开始旺盛，牙齿更换，头发生长。男子三十二岁，女子二十八岁，筋骨隆盛，肌肉满壮。形体肉血气，虽然依靠后天水谷滋养，但根本在于先天的生原。一天刺两次，是为了引导阴阳血气的生长。
黄帝说：面对深水开闸放水是怎么回事？岐伯说：如果血清气浊，快速泻法，会导致气竭。黄帝说：顺着挖掘决口疏通是怎么回事？岐伯说：如果血浊气涩，快速泻法，经络就可以通畅。
清浊，是天地之气。临深决水，循掘决冲，是运行的逆顺。血气逆顺运行，对应天地的旋转。
按语：这一篇论述形肉的厚薄坚脆，血气的多少清浊，对应太过不及之气。所以用针的深浅疾徐，刺法的多少补泻，都以针结合人体来引导其平和。因此全篇没有提到“邪病”二字。如果当作泻邪来论述，就远离了经义的本意。
黄帝说：脉运行的逆顺是怎样的？岐伯说：手之三阴经，从脏走向手；手之三阳经，从手走向头；足之三阳经，从头走向足；足之三阴经，从足走向腹。
黄帝说：为什么少阴经单独下行呢？岐伯说：不是这样的。冲脉，是五脏六腑的海，五脏六腑都禀受它。冲脉向上的部分，出于颃颡（鼻咽部），渗灌诸阳经，灌注精气；向下的部分，注入少阴的大络，出于气街，沿着大腿内侧，进入腘中，伏行于骨内，下行至内踝之后，分支别行。其向下的一支，并与少阴经并行，渗灌三阴经；其向前的一支，伏行出于足背，下行至足大趾间，渗灌各络脉以温养肌肉。所以如果别络结滞，足背就不跳动；不跳动就会厥冷，厥冷就会寒冷。黄帝说：怎么证明这一点呢？岐伯说：可以通过言语引导，切脉验证，看到足背确实有搏动，然后才能明白逆顺的运行。黄帝说：圣人的道真是高深啊！明如日月，细微到毫厘。如果不是夫子，谁能说得清楚呢？
这一段讲血气行于脉外，以应天道。司天在上，在泉在下，水天之气上下相通，对应人的血气充肤热肉，淡渗皮毛，使肌肉充满。如果怯然少气，则水道不行，形气消索。冲脉是五脏六腑的海，五脏六腑的气都禀受冲脉而行。向上的部分出于颃颡，渗灌诸阳，灌注诸阴；向下的部分注入少阴的大络，出于气街。这是五脏六腑的血气，都从冲脉渗灌于脉外的皮肤之间，对应水随气运行于天表。少阴主先天的水火，水火即精气。冲脉并少阴经，渗灌三阴，循足背入足大趾间，渗灌诸络以温养肌肉。这是少阴的精气，又从冲脉营运出入于经脉皮肤之外内。所以如果别络结滞，少阴之气就不能行于足背，足背就不跳动了。不跳动，是少阴之气厥于内，所以厥冷则寒。这是气血结于脉内，不能通于脉外。所以应当引导，用言语引导气外出，以脉验知精血之行。如果不是足背不动，就无法明白逆顺之行。逆顺之行，是指少阴的精气渗灌于肤表，又复营运于脉中，对应司天在泉之气绕地环转，又复通贯于地中。明如日月，微于毫厘，是说圣人的道，如日月丽天，循度环转，无有毫厘差失。所以说圣人的道，上合于天，下合于地，中合于人事，必须有明确的法则，确立度数法式，然后才可以传授。
杨元如说：五脏六腑，对应五运在中。五运，是神机的出入。皮肤经脉，对应六气在外。六气，是左右上下环转升降。五脏六腑之气，禀受冲脉营运于肤表，对应地气出于外。莫仲超说：所谓冲脉，顺行逆冲于经脉皮肤之外内，充于身形，无往不到，所以叫逆顺之行。经脉的血气顺行，则皮肤的气血逆转，以应天地营运之道。禀于五脏六腑的，即水谷所生的血气，流溢于中，由冲脉布散于皮肤之外。少阴的气血，是先天的精气，并冲脉渗于三阴，行于脉中，循足背渗足趾诸络，而出于脉外。所以阳气起于足五趾之表，阴气起于足五趾之里，是秉承足少阴先天的水火。人的形体肥浓，由水谷所生的血气充肤热肉，淡渗皮毛。其真骨坚，肉缓节监，是秉承先天的精气。皮肉筋骨，营卫血气，都本于先天后天生始的血气以资益，而后能筋骨强坚，肌肉丰浓。所以开始论人的肥瘦长短，最后归结于冲脉少阴的出入。
Huangdi asked Qibo: I have learned the principles of acupuncture from the Master, and the content is comprehensive and complete. The Master's Dao seems easy to grasp yet elusive, without any firm or fixed point to hold onto. Did the Master acquire this through熟习 (shúxí, familiarity) of learning, or by examining things and achieving sudden comprehension in the heart?
This chapter discusses how human body constitution (thick or thin), blood and qi (clear or turbid) correspond to the Dao of Heaven and Earth, and operate according to the principles of reverse and smooth (ni shun). "The Master's Dao seems elusive" means the Dao is profound and distant, hard to find; "firm" refers to being definite or fixed. "Examining things" means investigating the principles of phenomena; "sudden comprehension in the heart" refers to a state of enlightened understanding. Generally, the Dao of sages connects with Heaven and Earth and conforms to the regularities of things. Yang said: "Elusive and firm" refers to Yan Hui's description: "Drilling into it makes it harder; looking at it ahead, it suddenly appears behind."
Qibo replied: The Dao established by sages corresponds above to Heaven, below to Earth, and in between to human affairs. There must be clear laws to establish measurements, standards, and rules, so that they can be transmitted. Therefore, a carpenter cannot judge length or width without rulers and measures, nor level water without a plumb line; a craftsman cannot draw circles without a compass or squares without a square ruler. Those who understand using these tools know they are natural instruments, easy-to-use teachings, and the constant principles of reverse and smooth operation. Huangdi said: I wish to hear what "natural" means. Qibo said: Opening a sluice on deep water requires no brute force, and the water can be drained; following a dug channel to break through allows meridians to become unobstructed. This illustrates the slipperiness or sluggishness of qi, the clarity or turbidity of blood, and their reverse or smooth flow.
Qibo discussed the Dao of Heaven and Earth, which arises naturally without coercion. Although profound and difficult to understand, it does not go beyond the principles of compass and square. "Opening a sluice on deep water" refers to letting water flow out; "following a dug channel to break through" refers to guiding water in. This is the operation of reverse and smooth. Yang said: Compass and square represent the images of Heaven and Earth. Reverse and smooth refer to Earth Qi moving left and Heavenly Dao rotating right. Using no brute force is the spontaneity of creation.
Huangdi said: I wish to know if people of different complexions, fatness, leanness, height, and stature have specific numerical patterns. Qibo said: For those who are young and strong, with abundant blood and qi, and firm skin and flesh, if pathogenic factors are added, needling should be deep and retained. This applies to obese individuals. They have broad shoulders and armpits, thin neck muscles, thick black skin, and protruding lips. Their blood is dark and turbid, and their qi is sluggish and slow. Such people tend to be greedy in giving and taking. When needling them, one should needle deeply, retain the needles, and increase the number of sessions.
This section discusses excessive physical constitution (obesity). Broad shoulders mean wider than the surroundings. The neck is governed by the Taiyang meridian; thin neck muscles with thick black skin indicate abundant Taiyang Water Qi. Lips are the external manifestation of Spleen Earth; protruding lips indicate strong Earth Qi. Black is the color of Water; dark and turbid blood indicates heavy and turbid Essence-Water. Sluggish and slow qi is due to dense muscles causing obstruction in the qi pathways. Excess leads to ability to give; deficiency leads to greed. Those greedy in giving and taking lack the Dao of harmony; excess is similar to deficiency. Yang Yuanru said: The previous chapter discussed the Qi of the Five Zang organs corresponding to the thickness of Earth and the clarity/coarseness of Qi color; this chapter discusses body fatness/leanness and blood clarity/turbidity, corresponding to excess and deficiency. Skin, flesh, vessels, sinews, and bones are external combinations of the Five Zang organs. Zhu Jigong said: The Five Movements govern the interior, the Six Qi govern the exterior. Humans are born inheriting the luck of Heaven and Earth, thus often exhibiting excess or deficiency.
Huangdi said: How should one needle lean individuals? Qibo said: Lean individuals have thin skin, pale complexion, emaciated muscles, thin lips, and soft speech. Their blood is clear and qi is slippery; qi is easily depleted, and blood is easily damaged. When needling them, one should needle shallowly and withdraw quickly.
This section discusses deficient physical constitution (leanness). Thin skin and pale complexion indicate insufficient inheritance of Heavenly Qi. "Lianlian" describes a lean and clean appearance. Emaciated muscles, thin lips, and soft speech indicate insufficient inheritance of Earthly Qi. Clear blood means clear and shallow fluids. Slippery qi is because thin muscles allow smooth qi pathways. Mo Zhongchao said: Voice relates to Late Summer and thin Earth Qi, hence soft speech. Zhu Jigong said: The slipperiness or sluggishness of qi pathways depends on muscle thickness, corresponding to the movement of Heavenly Qi within Earth.
Huangdi said: How should one needle ordinary people? Qibo said: Observe their white or black complexion and regulate accordingly. Those with upright and solid constitutions have harmonious blood and qi. When needling them, do not deviate from standard measurements.
This section discusses the harmony of peaceful individuals. White and black are colors of Water and Heaven. Upright and solid reflect the virtue of Kun (Earth). These individuals inherit the peaceful Qi of Heaven and Earth, hence their blood and qi are harmonious. Standard measurements refer to the constants of Heaven and Earth. Essentially, humans correspond to the Qi of Heaven and Earth, and needling should align with the numbers of Heaven, Earth, and Humanity.
Huangdi said: How should one needle robust individuals with solid bones? Qibo said: For robust individuals with solid bones, if muscles are loose and joints prominent, and the person is heavy, then qi is sluggish and blood is turbid; needle deeply and retain, increasing the number of sessions. If the person is vigorous, then qi is slippery and blood is clear; needle shallowly and withdraw quickly.
This discusses individuals in their prime, inheriting complete innate truth. Innate Yuan Qi resides in the Kidneys, which govern bones. With complete innate truth, flesh and bones become full. Solid bones, loose muscles, and prominent joints indicate harmony of sinews and bones with full muscles. "Jianjian" means standing upright without leaning. Heavy and turbid constitution leads to sluggish qi and turbid blood; light and vigorous constitution leads to slippery qi and clear blood. Yuan Zhen is undifferentiated Qi, but after birth, distinctions of heaviness/lightness and high/low arise. Deep needling with retention, and shallow needling with quick withdrawal, guide qi in and out.
Huangdi said: How should one needle infants? Qibo said: Infants have fragile flesh, little blood, and weak qi. Use fine needles, needle shallowly, and withdraw quickly. It can be done twice a day.
This discusses infants who have not yet inherited full innate vigor, with fragile flesh, little blood, and weak qi. "Ying" refers to nursing in swaddling clothes. Generally, boys at age eight and girls at age seven begin to have vigorous Kidney Qi, replacing teeth and growing hair. Boys at age thirty-two and girls at age twenty-eight reach peak bone and sinew development and full muscle strength. Form, flesh, blood, and qi rely on postnatal grain and water for nourishment, but originate from prenatal life source. Twice daily needling guides the growth of Yin-Yang, blood, and qi.
Huangdi said: What about opening a sluice on deep water? Qibo said: If blood is clear and qi is turbid, rapid draining will deplete the qi. Huangdi said: What about following a dug channel to break through? Qibo said: If blood is turbid and qi is sluggish, rapid draining will unblock the meridians.
Clear and turbid refer to the Qi of Heaven and Earth. Opening a sluice on deep water and following a dug channel to break through represent reverse and smooth operation. Blood and qi flowing in reverse or smooth order correspond to the rotation of Heaven and Earth.
Note: This chapter discusses the thickness, thinness, solidity, and fragility of form and flesh, and the quantity and clarity/turbidity of blood and qi, corresponding to excess and deficiency Qi. Therefore, the depth, shallowness, speed, and slowness of needling, as well as the quantity and tonification/reduction methods, all use needles to harmonize the human body. Thus, the term "pathogenic disease" does not appear in the chapter. Interpreting it merely as draining pathogens would stray far from the meaning of the Classic.
Huangdi said: What is the reverse and smooth flow of meridians? Qibo said: The Three Yin meridians of the Hand travel from the Zang organs to the hands; the Three Yang meridians of the Hand travel from the hands to the head; the Three Yang meridians of the Foot travel from the head to the feet; the Three Yin meridians of the Foot travel from the feet to the abdomen.
This discusses the reverse and smooth flow of Yin and Yang meridians of the hands and feet, up and down, outside and inside, corresponding to rivers on Earth.
Huangdi said: Why does only the Shaoyin meridian descend? Qibo said: Not so. The Chong Mai (Penetrating Vessel) is the Sea of the Five Zang and Six Fu organs; all Zang and Fu organs receive from it. Its ascending branch emerges from the pharynx (hangsang), seeps into the Yang meridians, and irrigates the essences. Its descending branch pours into the large collateral of Shaoyin, emerges at the Qichu (gas street), follows the medial aspect of the thigh, enters the popliteal fossa, runs deep within the bone, descends to behind the medial malleolus, branches off, and separates. The lower part runs parallel with the Shaoyin meridian, seeps into the Three Yin meridians. The anterior part runs deep, emerges at the dorsum of the foot, descends, follows the dorsum, enters between the great toe and second toe, seeps into various collaterals to warm the muscles. Therefore, if the collateral collides, the dorsum of the foot becomes immobile; immobility leads to cold limbs (Jue), and cold limbs lead to coldness. Huangdi said: How do we know this? Qibo said: By verbal guidance and pulse palpation verification; seeing the actual movement, one can then understand the reverse and smooth flow. Huangdi said: How profound! The Dao of sages is bright like the sun and moon, subtle to the finest detail. Without the Master, who could explain it?
This section discusses blood and qi flowing outside the vessels, corresponding to the Dao of Heaven. Si Tian (ruling Heaven) is above, Zai Quan (ruling Earth) is below; Water and Heaven Qi connect above and below, corresponding to human blood and qi filling the skin, warming the flesh, and seeping into the pores, making muscles full. If one feels timid and short of breath, water pathways fail, and form and Qi dissipate. The Chong Mai is the Sea of the Five Zang and Six Fu organs; the Qi of all Zang and Fu organs flows via the Chong Mai. Its ascending branch emerges from the pharynx, seeps into Yang meridians, irrigates Yin. Its descending branch pours into the large collateral of Shaoyin, emerging at Qichu. This means the blood and qi of the Five Zang and Six Fu organs seep and irrigate the skin outside the vessels from the Chong Mai, corresponding to water moving with Qi on the surface of Heaven. Shaoyin governs prenatal Water and Fire; Water and Fire are Essence and Qi. The Chong Mai runs with Shaoyin, seeps into the Three Yin, follows the dorsum of the foot, enters the great toe, seeps into collaterals to warm muscles. This is the Essence-Qi of Shaoyin, circulating in and out of the vessels and skin via the Chong Mai. Therefore, if collaterals collide, Shaoyin Qi cannot reach the dorsum of the foot, causing immobility. Immobility means Shaoyin Qi is reversed internally, leading to cold limbs and coldness. This is Qi and Blood stagnating inside the vessels, unable to communicate outside. Thus, guidance is needed: verbal guidance to move Qi outward, pulse verification to know Jing-Blood flow. Only when the dorsum of the foot is immobile can one understand the reverse and smooth flow. Reverse and smooth flow means the Essence-Qi of Shaoyin seeps into the skin surface and circulates back within the vessels, corresponding to Si Tian and Zai Quan Qi circling the earth and penetrating underground. Bright like sun and moon, subtle to the finest detail, means the Sage's Dao is like the sun and moon in the sky, circling according to degrees without error. Thus, the Sage's Dao corresponds above to Heaven, below to Earth, and in between to Human affairs, requiring clear laws and measurements for transmission.
Yang Yuanru said: The Five Zang and Six Fu organs correspond to the Five Movements in the interior. The Five Movements are the entry and exit of Shen Ji (Spirit Mechanism). Skin and meridians correspond to the Six Qi in the exterior. The Six Qi are the circular rotation and ascent/descent of left, right, up, and down. The Qi of the Five Zang and Six Fu organs inherits from the Chong Mai and circulates on the skin surface, corresponding to Earth Qi emerging outward. Mo Zhongchao said: The so-called Chong Mai moves forward and reverses inside and outside the meridians and skin, filling the body, reaching everywhere, hence called reverse and smooth operation. When meridian blood and qi flow smoothly, skin Qi and blood reverse, responding to the operational Dao of Heaven and Earth. Inherited from the Five Zang and Six Fu organs refers to blood and qi generated from grain and water, overflowing internally, distributed to the exterior of the skin via the Chong Mai. Shaoyin blood and qi are prenatal Essence-Qi, merging with Chong Mai to seep into the Three Yin, flowing within vessels, following the dorsum of the foot, seeping into toe collaterals, and exiting outside vessels. Thus, Yang Qi originates from the exterior of the five toes, and Yin Qi from the interior of the five toes, inheriting the prenatal Water and Fire of Foot Shaoyin. Human body fatness and thickness result from blood and qi generated by grain and water filling the skin, warming the flesh, and seeping into pores. Solid bones, loose muscles, and prominent joints inherit prenatal Essence-Qi. Skin, flesh, sinews, bones, Ying-Wei, blood, and qi all originate from prenatal and postnatal life-source blood and qi for nourishment, enabling strong sinews/bones and thick muscles. Thus, beginning with discussions of fatness/leanness and height/shortness, it concludes with the entry and exit of Chong Mai and Shaoyin.