Lingshu · Explaining the Small Needle

The text

What is called easy to set forth means easy to speak. Hard to enter means hard to lodge in a person. The coarse keep the form: they keep the method of piercing. Those above keep the spirit: they keep whether a person's blood and qi have a remainder or are insufficient, and whether one may replenish or drain. Spirit and guest: the meeting of the upright and the pathogenic. Spirit is upright qi. The guest is pathogenic qi. At the gate: pathogen follows the places where upright qi goes out and comes in. Not yet having seen the illness: first know on which channel the pathogenic and the upright have their illness. How can one know its origin: first know the illness of the channel it belongs to, and the place that is to be taken. The subtlety of piercing is in count and delay: this is the intent of slow and swift. The coarse keep the passes: they keep the four limbs and do not know the coming and going of blood and qi, of the upright and the pathogenic. Those above keep the trigger: they know how to keep qi. The movement of the trigger does not leave its hollow: they know the vacant and the replete of qi, and the slow and swift of using the needle. The trigger within the hollow is clear, still, and faint: with the needle one obtains qi; keep qi closely by intent and do not lose it. Its coming cannot be met: when qi is abundant one cannot replenish. Its going cannot be pursued: when qi is vacant one cannot drain. Cannot hang a hair upon it: this says qi is easily lost. Knock and it does not fire: this says one does not know the intent of replenishing and draining; blood and qi are already exhausted, and qi does not descend. Know its coming and going: know the against and the with of qi, its abundance and vacancy. The essential is to meet it at its time: know the time when qi may be taken. How dark the coarse are: they are dim and do not know the faint closeness of qi. How subtle this is — the worker alone has it: they know the intent of the needle to the end. What goes is against: this says qi is vacant and small; what is small is against. What comes is with: this says form and qi are level; what is level is with. Know clearly the against and the with, and go straight without a gap: this says one knows the place that is to be taken. To meet and seize it is to drain. To pursue and assist it is to replenish. What is called when vacant, fill it: the qi-opening is vacant, and one should replenish it. When full, drain it: the qi-opening is abundant, and one should drain it. When old and stagnant, remove it: take away the blood vessels. When pathogen prevails, empty it: this says that wherever the channels have abundance, one drains their pathogen. Slow then swift makes replete: this says insert slowly and withdraw swiftly. Swift then slow makes vacant: this says insert swiftly and withdraw slowly. Speaking of replete and vacant, as if there, as if not: this says the replete have qi, the vacant have no qi. Watch what comes after and what comes first, as if gone, as if remaining: this says the vacant and replete of qi, the first and last of replenishing and draining; watch whether qi has already descended or still remains as usual. Making vacant and replete, as if obtaining, as if losing: this says that when one replenishes there is a fullness as if one had obtained; when one drains there is a faintness as if one had lost. When qi is in the vessels, pathogenic qi is above: this says pathogenic qi strikes a person high, therefore pathogenic qi is above. Turbid qi is in the center: this says water and grain all enter the stomach; their refined qi pours upward into the lung, the turbid flows in the intestines and stomach; this says cold and warmth miss what is fitting, food and drink miss their measure, and illness is born in the intestines and stomach — therefore it is named turbid qi in the center. Clear qi is below: this says the qi of clear damp of the earth, when it strikes a person, must begin from the feet — therefore it is said: clear qi is below. Needle a sunken vessel and pathogenic qi goes out: take it above. Needle a mid-vessel and turbid qi goes out: take the joining of yangming. Needle too deep and pathogenic qi sinks again: this says an illness that is shallow and floating does not wish deep piercing; if deep, pathogenic qi follows it in — therefore it is said it sinks again. Skin, flesh, sinew, and vessel each have their place: this says the channel networks each have what they govern. To take the five vessels is death: this says the illness is in the center, qi is insufficient, and one only uses the needle to drain to the end the various yin vessels. To take the three yang vessels: this only says one drains to the end the qi of the three yang, and makes the one who is ill collapse and not recover. To seize yin is death: this says taking Wuli of the chi — five goings. To seize yang is mania: this is spoken straight. See the color, examine the eyes, know the scattering and returning; unify the form, listen to stillness and movement: this says those above know how to read the five colors in the eyes, and know how to attune the chi and the cun — large and small, slow and urgent, slippery and rough — and thereby speak the illness. Know the pathogenic and the upright: know how to discuss the wind of vacant pathogen and upright pathogen. The right governs pushing it, the left holds and guides it: this says holding the needle as it goes out and comes in. When qi arrives, leave it: this says replenish and drain until qi is attuned, then leave it. Attuning qi lies in beginning and end as one: it is holding the heart. The meetings of the joints, three hundred and sixty-five assemblies: these are where the collateral vessels seep and irrigate the various joints. What is called the qi of the five zang already cut off within: the inner qi of the pulse-opening is cut off and does not arrive; instead one takes the place of illness without and the joining of the yang channels, leaves the needle to bring yang qi; when yang qi arrives, the inner is doubly exhausted; doubled exhaustion, and then death. The death has no qi with which to move — therefore it is still. What is called the qi of the five zang already cut off without: the outer qi of the pulse-opening is cut off and does not arrive; instead one takes the transports of the four extremities, leaves the needle to bring yin qi; when yin qi arrives, yang qi enters again; entering, it is against; against, and then death. The death has yin qi with a remainder — therefore it is restless. Why one examines the eyes: the five zang send the five colors to follow and be bright; when they follow and are bright, the voice is clear; when the voice is clear, this says the voice differs from ordinary life.

The line

Those above keep the spirit: they keep whether a person's blood and qi have a remainder or are insufficient, and whether one may replenish or drain.

The note

Explaining the Small Needle is speaking the Nine Needles and Twelve Origins once more. To keep the spirit is to keep the remainder and the insufficiency of blood and qi. The explanation is lest a person hear spirit as something vacant and strange.