Suwen · Needling With and Against the Four Seasons

The text

When jueyin has a remainder, the illness is yin impediment. When insufficient, the illness gives birth to heat impediment. If slippery, the illness is fox-shan wind. If rough, the illness is accumulated qi in the lesser abdomen. When shaoyin has a remainder, the illness is skin impediment and hidden rash. When insufficient, the illness is lung impediment. If slippery, the illness is lung-wind shan. If rough, the illness is accumulation and blood in the urine. When taiyin has a remainder, the illness is flesh impediment and cold in the center. When insufficient, the illness is spleen impediment. If slippery, the illness is spleen-wind shan. If rough, the illness is accumulation, and the heart and abdomen are at times full. When yangming has a remainder, the illness is vessel impediment, the body at times hot. When insufficient, the illness is heart impediment. If slippery, the illness is heart-wind shan. If rough, the illness is accumulation, and at times one is given to fright. When taiyang has a remainder, the illness is bone impediment, the body heavy. When insufficient, the illness is kidney impediment. If slippery, the illness is kidney-wind shan. If rough, the illness is accumulation, and at times one is given to peak-illness. When shaoyang has a remainder, the illness is sinew impediment and fullness in the flanks. When insufficient, the illness is liver impediment. If slippery, the illness is liver-wind shan. If rough, the illness is accumulation, and at times the sinews are urgent and the eyes ache. Thus spring qi is in the channel vessels; summer qi is in the minute collaterals; late-summer qi is in the flesh; autumn qi is in the skin; winter qi is in the marrow of the bones. The Emperor said: I wish to hear the reason. Qi Bo said: In spring, Heaven's qi first opens, Earth's qi first leaks; frost unbinds, ice is loosed; water travels and the channels communicate. Thus a person's qi is in the vessels. In summer the channels are full, qi overflows, enters the minute collaterals and receives blood; the skin is replete. In late summer the channels and collaterals are all abundant; they overflow inward into the flesh. In autumn Heaven's qi first gathers; the interstices are closed and blocked; the skin draws tight. In winter there is covering and storing; blood and qi are in the center, clinging inward to the marrow, communicating with the five zang. Thus pathogenic qi always follows the blood and qi of the four seasons and enters as a guest. As for its changes, they cannot be measured — yet you must follow the channel-qi, drive out the pathogen. Drive out the pathogen, and disordered qi is not born. The Emperor said: Going against the four seasons and giving birth to disordered qi — how is it? Qi Bo said: Needling the collateral vessels in spring: blood and qi overflow outward, making a person scant of qi. Needling the flesh in spring: blood and qi circle in counterflow, making qi rise. Needling the sinews and bones in spring: blood and qi cling inward, making the belly swell. Needling the channel vessels in summer: blood and qi are then exhausted, making a person slack and weary. Needling the flesh in summer: blood and qi withdraw inward, making a person given to fear. Needling the sinews and bones in summer: blood and qi reverse upward, making a person given to anger. Needling the channel vessels in autumn: blood and qi reverse upward, making a person given to forgetting. Needling the collateral vessels in autumn: qi does not travel outward, making a person lie down and not wish to move. Needling the sinews and bones in autumn: blood and qi scatter inward, making a person shiver with cold. Needling the channel vessels in winter: blood and qi both slip away, making a person's eyes not bright. Needling the collateral vessels in winter: inner qi leaks outward and stays as a great impediment. Needling the flesh in winter: yang-qi is exhausted and cut off, making a person given to forgetting. All these needlings of the four seasons: the illness of great going-against — one cannot but follow. To reverse them is to give birth to disordered qi and seeping illness. Thus if one needles without knowing the channels of the four seasons, and where illness is born, one takes what is with as if it were against; upright qi is disordered within and clashes with jing. You must examine the nine indicators. Then upright qi is not disordered; jing-qi does not turn. The Emperor said: Good. Needling the five zang: if you strike the heart, one dies in a day; its movement is belching. If you strike the liver, one dies in five days; its movement is talking. If you strike the lung, one dies in three days; its movement is coughing. If you strike the kidney, one dies in six days; its movement is sneezing and yawning. If you strike the spleen, one dies in ten days; its movement is swallowing. If needling injures a person's five zang, it must be death. The movement follows the changed signs of that zang — by this one knows the death.

The line

Thus spring qi is in the channel vessels; summer qi is in the minute collaterals; late-summer qi is in the flesh; autumn qi is in the skin; winter qi is in the marrow of the bones.

The note

Spring qi is in the channel vessels; summer qi is in the minute collaterals. To needle against and with the four seasons is to let the hand follow Heaven, not to let Heaven follow the hand.