Suwen · The Parting and Meeting of True and Pathogenic

The text

The Yellow Emperor asked: I have heard the nine needles in nine chapters; you then took those nine and nined them again — nine nines are eighty-one chapters — and I have understood their meaning in full. The classic says that qi has fullness and decline, that it tilts and shifts left and right; that one regulates the below by the above, the right by the left; that surplus and insufficiency are replenished and drained at the ying and the transport points — this I know. These are all the tilting and shifting of ying and wei, the birth of vacuity and repletion; they are not pathogenic qi entering the channels from outside. I wish to hear of pathogenic qi that is in the channels: what the person is like, and how one takes it. Qi Bo answered: When the sage sets up measures and numbers, they must answer heaven and earth. Thus heaven has the measures of the lodges; earth has the channel-waters; the person has the channel vessels. When heaven and earth are mild and warm, the channel-waters are quiet. When heaven is cold and the earth is frozen, the channel-waters congeal and weep. When heaven is hot and the earth is burning, the channel-waters boil and overflow. When a sudden wind rises violently, the channel-waters surge in waves and rise in ridges. When pathogen enters the vessels, cold makes the blood congeal and weep; heat makes the qi moist and sleek. Vacant pathogen that enters as a guest is also like the channel-waters taking the wind. The moving vessel of the channel, when it arrives, also at times rises in a ridge; it travels in the vessel in an orderly way; when it reaches the inch-opening and fills the hand, it is now large, now small. When large, the pathogen has arrived; when small, it is level. Its travel has no fixed place, in yin and in yang, and cannot be given a measure. Follow and examine it by the three regions and nine assessments; when you suddenly meet it, stop its road early. On the in-breath, insert the needle; do not let the qi clash. Stay quiet and leave it long; do not let the pathogen spread. On the in-breath, turn the needle; take obtaining qi as the purpose. Wait for the out-breath to withdraw the needle; when the out-breath is finished, then leave; the great qi all goes out. Therefore it is named draining. The Emperor said: When there is insufficiency, how does one replenish it? Qi Bo said: You must first feel and follow it, press and scatter it, push and press it, flick it so it rises, pinch and bring it down, open and take it. Draw the gate outward, so as to close in the spirit. When the out-breath is finished, insert the needle; stay quiet and leave it long; take the arrival of qi as the purpose — as one waits for an honored guest, not noticing the day has dusked. When its qi has arrived, fittingly protect it yourself. Wait for the in-breath to withdraw the needle, so qi cannot go out; each remains in its place. Push the gate shut; let the spirit-qi remain; the great qi stays. Therefore it is named replenishing. The Emperor said: How does one watch for the qi? Qi Bo said: When the pathogen leaves the collaterals and enters the channels, it lodges in the blood vessels. Its cold and warmth have not yet settled with each other, like a surging wave rising; it comes and goes in time, and so it is not always there. Therefore it is said: just as it comes, you must press and stop it; stop it, then take it; do not meet its onrush and drain it. True qi is the channel qi. When the channel qi is greatly vacant, therefore it is said: its coming cannot be met — this is what is meant. Therefore it is said: if you watch the pathogen without care, and the great qi has already passed, draining then strips the true qi; once stripped it does not return; pathogenic qi comes again, and the illness stores up still more. Therefore it is said: its going cannot be pursued — this is what is meant. Not to be off by a hair means: wait for the moment the pathogen arrives, then release the needle and drain. If too early or too late, blood and qi are already exhausted, and the illness cannot be brought down. Therefore it is said: knowing when it can be taken is like releasing a trigger; not knowing when to take it is like knocking on a wooden stake. Therefore it is said: one who knows the Dao of the trigger cannot be off by a hair; one who does not know the trigger knocks and it does not fire — this is what is meant. The Emperor said: How does one replenish and drain? Qi Bo said: This is attacking the pathogen. Bring it out quickly to remove the overflowing blood, and restore the true qi. This pathogen is a new guest, dissolving, not yet settled in a place. Push it and it goes forward; draw it and it stops. Needle against it — this is the warm blood. Needle it out as blood, and the illness ends at once. The Emperor said: Good. Yet when the true and the pathogenic have already joined, and the wave-ridges do not rise, how does one watch for it? Qi Bo said: Carefully feel and follow the fullness and vacuity of the three regions and nine assessments, and regulate them. Examine what is lost or reduced between left and right, above and below; examine which zang is ill, and time it accordingly. One who does not know the three regions does not tell yin from yang, does not divide heaven from earth. By earth watch earth, by heaven watch heaven, by the person watch the person; regulate at the central fu, so as to fix the three regions. Therefore it is said: if in needling you do not know the place of the illness-pulse in the three regions and nine assessments, even when a great excess is about to arrive, the artisan cannot hold it back. To punish what has no fault is named great confusion: it disorders the great channels in return; the true cannot be restored. To take repletion for vacuity, to take the pathogenic for the true, to use the needle without principle, is to become, instead, a thief of qi. It seizes the person's upright qi, takes what follows as if it were against; ying and wei scatter in disorder; true qi is already lost; the pathogen alone lodges within; it cuts off the person's long life and gives an early calamity. Not knowing the three regions and nine assessments, one cannot last long. Because they do not know how to join this to the four seasons and five phases, they add one overcoming another, release the pathogen and attack the true, and cut off the person's long life. When the pathogen comes as a new guest, it has no settled place; push it and it goes forward; draw it and it stops; meet it and drain it, and the illness ends at once.

The line

True qi is the channel qi; when the channel qi is greatly vacant, therefore it is said: its coming cannot be met — this is what is meant.

The note

The true and the pathogenic will meet. To replenish and to drain is to let true qi walk its own road again. Parting and meeting is not a war; it is sending out what came in at the wrong door.