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.Also, if a repeated piercing into the foot minor yang conduit remains with-out noticable effect, the healer is advised to pierce the hand heart ruler con-duit, that is, the hand ceasing yin conduit, and the hand major yin conduit.While the former passes near the armpits, the latter does not touch this re-gion in a way that one could imagine a point suitable for draining an abscessin the armpit.Hence it may well be that the piercing recommended herewas thought either to influence the qi in the conduits in a way that reducedthe heat or to exert a curative impact that was unrelated to qi manipulation.The same may be said in view of the subsequent recommendation for treat-ing cholera and convulsions resulting from fright:In the case of cholera, pierce five transporters on [both] sides, andthree on both sides of the foot yang brilliance [conduit], and above.To pierce convulsions resulting from fright, [select] five [locations on the]vessels:pierce the hand major yin [conduits] at five [locations] each;pierce the foot major yang [conduit] at five [locations];pierce one [location] on both sides of the hand minor yin conduit-network[vessels], and [also]the foot yang brilliance [conduit at] one [location].Move five inches upward from the ankle and insert three needles [there].715 Unschuld,Huang Di nei jing 12/2/02 1:34 PM Page 280280 survey of the contents of the su wenAnother example of such ambiguous advice is Su wen 32.In the case of aheat disease in the liver, the recommendation given is to pierce the footceasing yin and the [foot] minor yang [conduits]. 716 The former is associ-ated with the liver and the latter with the gall.It may well be that this ma-nipulation is solely aimed at the qi, but it could also have been meant to letblood, or simply to repeat an efficacious procedure without concern for un-derlying physiological processes.The wording of the advice suggests the ex-istence of insider knowledge, in that the author of the text must have takenit for granted that his readers knew the rationale for such interventions.It is only in Su wen 59 that we begin to move onto solid ground regard-ing a piercing that is explicitly directed at the manipulation of qi.Here al-together 365 holes are listed on the foot major yang, the foot minor yang,the foot yang brilliance, the hand yang brilliance, the hand major yang, thehand minor yang, the foot minor yin, the hand minor yin, the supervisor,the controller, the thoroughfare, the yin and yang walker vessels, the vesselbelow the tongue, the ceasing yin vessels in the pubic hair, and locations atthe fish lines of the hands and the feet, where the qi can be effused throughinsertion of a needle.Su wen 62, in addition to giving advice on bloodletting, offers a few pas-sages on genuine qi manipulation.Once again, Huang Di asks Qi Bo howto proceed to drain a repletion or to supplement a depletion.The resultingdialogue is unambiguous:[Huang] Di:When blood and qi have collected,when the disease has assumed a physical manifestation, andwhen yin [qi] and yang [qi] pour into each other s [domain],to supplement and drain [in such a situation], how to proceed?Qi Bo:To drain a repletion, insert the needle when the qi abounds.The needle enters together with the qi.This serves to open the gate as if a door leaf was made to move freely.When the needle leaves together with the qi, the essence qi is not harmed, andthe evil qi descends.Do not close the outside gate,so that the disease is made to leave.Widen its way by moving [the needle] here and there,as if its road was made passable.{This is called massive drainage. }It is essential to squeeze [the arm] and make [the qi] leave.[As a result], large [quantities of] qi will yield.[Huang] Di:To supplement a depletion, how to proceed? Unschuld,Huang Di nei jing 12/2/02 1:34 PM Page 281survey of the contents of the su wen 281Qi Bo:Hold the needle, but do not position it yet.In this way stabilize [your] intentions.Wait for an exhalation to insert the needle.When the qi leaves [the patient s mouth], introduce the needle.The needle hole is obstructed on four [sides], andthe essence [qi] has no [possible exit] from which it could leave.Right at the moment of repletion quickly remove the needle.When the qi enters [the patient s mouth], withdraw the needle,lest the heat returns.Obstruct its gate.The evil qi will disperse.As a result, the essence qi is preserved.To move the qi, wait for the [proper] time.The qi nearby is not lost.As a result, the qi far away will arrive.This is called pursuing it. 717The Su wen, we learn from these few paragraphs and some others notquoted here, is not a repository of exhaustive theoretical reasoning or clin-ical recommendations for genuine qi manipulation by means of acupunc-ture.Rather, the text combines a broad spectrum of concepts and approachesdeveloped around effects that may have been observed after the piercing ofpatients.Few of these concepts and approaches have survived the centuriesto be recognized as basic for the practice of acupuncture today.One finalexample of such traditions that have been lost long ago is what we may callmorphological piercing, as outlined in the next section.10.6
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