Suwen · A Thorough Appraisal of Vacuity and Repletion

The text

The Yellow Emperor asked: What is called vacuity and repletion? Qi Bo answered: When pathogenic qi is abundant, there is repletion; when jing-qi is seized, there is vacuity. The Emperor said: What are vacuity and repletion like? Qi Bo said: Vacuity of qi is vacuity of the lung; qi going against its course makes the feet cold. If it is not its time, the person lives; if it is its time, the person dies. The other zang are all like this. The Emperor said: What is called double repletion? Qi Bo said: What is called double repletion means a great heat illness: the qi is hot and the pulse is full. This is called double repletion. The Emperor said: When channels and collaterals are both replete, what is it like, and how does one treat it? Qi Bo said: When channels and collaterals are both replete, the inch pulse is tight and the cubit is slack. Both should be treated. Therefore it is said: slippery is following; rough is against. Vacuity and repletion all begin from the kinds of things. Thus when the five zang, the bones, and the flesh are slippery and unimpeded, one can last long. The Emperor said: When collateral qi is insufficient and channel qi has surplus, what is it like? Qi Bo said: When collateral qi is insufficient and channel qi has surplus, the pulse-opening is hot and the cubit is cold. In autumn and winter this is against; in spring and summer this is following. Treat what is governing the illness. The Emperor said: When the channels are vacant and the collaterals are full, what is it like? Qi Bo said: When the channels are vacant and the collaterals are full, the cubit is hot and full, the pulse-opening cold and rough. In spring and summer such a one dies; in autumn and winter, lives. The Emperor said: How does one treat this? Qi Bo said: When the collaterals are full and the channels vacant, moxa the yin and needle the yang. When the channels are full and the collaterals vacant, needle the yin and moxa the yang. The Emperor said: What is called double vacuity? Qi Bo said: When the pulse-qi above is vacant and the cubit is vacant, this is called double vacuity. The Emperor said: How does one treat it? Qi Bo said: What is called vacuity of qi means there is no constancy. Vacuity of the cubit means walking in fear. Vacuity of the pulse means it does not resemble yin. In such a one, slippery lives, rough dies. The Emperor said: When cold qi suddenly rises, and the pulse is full and replete, what is it like? Qi Bo said: Replete and slippery, the person lives; replete and against, the person dies. The Emperor said: When the pulse is replete and full, the hands and feet cold, the head hot, what is it like? Qi Bo said: In spring and autumn the person lives; in winter and summer, dies. A pulse that is floating and rough — rough, and the body has heat — dies. The Emperor said: When the form is entirely full, what is it like? Qi Bo said: When the form is entirely full, the pulse is tight, large, and hard, and the cubit is rough and does not answer. In such a one, following lives, going against dies. The Emperor said: What is meant by following lives, going against dies? Qi Bo said: What is called following is that the hands and feet are warm. What is called against is that the hands and feet are cold. The Emperor said: When a nursing mother has a heat illness, and the pulse is hanging and small, what is it like? Qi Bo said: If the hands and feet are warm, she lives; if cold, she dies. The Emperor said: When a nursing mother is struck by wind-heat, panting and wheezing, breathing from the shoulders — what is the pulse like? Qi Bo said: One who pants and wheezes and breathes from the shoulders has a pulse that is replete and large. If it is slack, she lives; if tight, she dies. The Emperor said: Intestinal flux with bloody stool — what is it like? Qi Bo said: If the body is hot, the person dies; if cold, lives. The Emperor said: Intestinal flux with white foam below — what is it like? Qi Bo said: If the pulse is sunken, the person lives; if floating, dies. The Emperor said: Intestinal flux with pus and blood below — what is it like? Qi Bo said: If the pulse hangs and is cut off, the person dies; if slippery and large, lives. The Emperor said: Among the kind of intestinal flux, when the body is not hot and the pulse does not hang cut off, what is it like? Qi Bo said: Slippery and large is said to live; hanging and rough is said to die. Time it by the zang. The Emperor said: Withdrawal illness — what is it like? Qi Bo said: If the pulse beats large and slippery, in time it ends of itself. If the pulse is small, hard, and tight, it is death, and cannot be treated. The Emperor said: In the pulse of withdrawal illness, what of vacuity and repletion? Qi Bo said: If vacant, it can be treated; if replete, death. The Emperor said: In wasting-heat, what of vacuity and repletion? Qi Bo said: If the pulse is replete and large, even after a long illness it can be treated. If the pulse is hanging, small, and hard, after a long illness it cannot be treated. The Emperor said: The measures of form, of bone, of vessel, of sinew — how does one know these measures? The Emperor said: In spring, treat the channels and collaterals at once; in summer, treat the channel transport points at once; in autumn, treat the six fu at once; in winter there is closing and blocking. When there is closing and blocking, use medicines and few needles or stones. What is meant by few needles or stones is not said of welling-abscess and flat-abscess; welling-abscess and flat-abscess cannot wait a moment to turn. When an abscess is not known as to place, pressing does not answer the hand, and it comes and goes suddenly — needle beside the hand Taiyin three scars, and the neck vessels two each. For an abscess in the armpit with great heat, needle the foot Shaoyang five times; if after needling the heat does not stop, needle the hand Heart-Governor three times; needle the channels and collaterals of the hand Taiyin, at the meeting of the great bones, three each. For a sudden abscess with sinews slack, pain following the divisions, corporeal sweat that does not finish, and insufficiency of womb-qi — treat at the channel transport points. For a belly suddenly full, that pressing does not bring down — take the channels and collaterals of the hand Taiyang, the collecting point of the stomach; the Shaoyin transport, three cun from the spine, five beside; use a round sharp needle. For sudden turmoil, needle five beside the transport points, and the foot Yangming and three above beside. For needling the pulse of fright-clonic illness, five: needle the hand Taiyin five each; needle the Taiyang channel five; needle beside the channels and collaterals of the hand Shaoyin, one; the foot Yangming, one; five cun above the ankle, needle three needles. In treating wasting-heat, falling as if struck, one-sided withering, wilting and reversal, qi fullness that issues against its course — in the fat and the noble, these are illnesses of rich and greasy fare. Blockage, obstruction, closing, and cutting off, above and below not passing through — these are illnesses of sudden grief. Sudden reversal and deafness, one-sided blockage that will not open — this is inner qi suddenly pressing. Illness of wind that does not follow from outside or inside, and so thinness that stays and lodges. Lameness of the instep is an illness of cold, wind, and damp. The Yellow Emperor said: Yellow-damp, sudden pain, withdrawal illness, reversal and mania — these are born of a long going-against. The five zang not level, the six fu closed and blocked — this is what they are born of. Headache and ringing in the ears, the nine orifices not free — these are born of the intestines and stomach.

The line

Qi Bo answered: When pathogenic qi is abundant, there is repletion; when jing-qi is seized, there is vacuity.

The note

Vacuity and repletion are this one sentence. The rest are its shadows. A thorough appraisal means looking at the whole — do not see only the side that has swollen.