Lingshu · The Upper Diaphragm

The text

The Yellow Emperor said: When qi makes the upper diaphragm, food and drink enter and come back out — this I already know. When worms make the lower diaphragm, food comes out only after a full day-cycle — this I have not yet grasped. I wish to hear it through to the end. Qi Bo said: When joy and anger are not fitting, when food and drink are not kept in measure, when cold and warmth miss their time, then cold juices flow into the intestines. Flowing into the intestines, the worms grow cold; when the worms grow cold they gather and accumulate, and keep to the lower tube. Then the intestines and stomach fill their walls; wei qi does not nourish; pathogenic qi dwells there. When the person eats, the worms rise to eat; when the worms rise to eat, the lower tube is vacant; when the lower tube is vacant, pathogenic qi overcomes it. The accumulation has already stayed; staying, a swelling is completed; when the swelling is completed, the lower tube is bound. If the swelling is inside the tube, it is immediate and the pain is deep. If the swelling is on the outside, the swelling is outward and the pain is floating, and the skin above the swelling is hot. The Yellow Emperor said: How is it needled? Qi Bo said: Press the swelling lightly; watch where the qi travels. First needle shallowly beside it, then a little inward and a little deeper, then return and needle it. Do not go beyond three passes. Observe whether it is sunken or floating, and take that as the measure of deep and shallow. After needling, you must apply a warm iron, so that heat enters the center. Day by day let heat go inward; pathogenic qi grows weaker, and the great swelling then breaks. Array this with the three prohibitions, to clear what is within. Quiet, without forcing — then qi can travel. Afterward use the salty and the bitter; the transformed grain will then go down.

The line

The Yellow Emperor said: When qi makes the upper diaphragm, food and drink enter and come back out — this I already know.

The note

Food that enters and comes back out is the qi of the upper diaphragm blocking the road. The diaphragm is a door. When the door is reversed, grain cannot find the sea.