Treating Qi Stagnation: Huangdi’s Classic Insights on Acupuncture

Huangdi said: When Wei Qi (Defensive Qi) stagnates in the chest and abdomen, its movement is obstructed, deviating from its normal course. This leads to symptoms such as distension in the chest, flanks, and stomach, breathlessness, and reverse flow of Qi. How should these conditions be treated?

Bergao replied: For Qi stagnation in the chest, use acupoints located on the upper body; for Qi stagnation in the abdomen, use acupoints on the lower body; for widespread stagnation in the chest and abdomen, use acupoints on both the upper and lower body, as well as nearby areas.

Huangdi asked: Which specific acupoints should be used?

Bergao answered: When Wei Qi stagnates in the chest, drain the Renying (ST9) acupoint on the Stomach Meridian of Foot Yangming, the Tiantu (CV22) acupoint, and the Lianquan (CV23) acupoint on the Conception Vessel Meridian. When stagnation occurs in the abdomen, drain the Zusanli (ST36) and Qijie (ST30) acupoints on the Stomach Meridian of Foot Yangming. For widespread stagnation causing distension in the chest, flanks, and stomach, drain the Renying, Tiantu, and Lianquan acupoints on the upper body, and the Zusanli, Qijie, and Zhangmen (LR13) acupoint below the ribs on the lower body. For severe conditions, use the chicken foot needling method. If the patient’s pulse is large and tense, or absent, and the abdominal skin is taut, avoid acupuncture.

Huangdi praised Bergao and continued: How should one diagnose the pathological changes in the skin, flesh, Qi, blood, tendons, and bones?

Bergao explained: If the disease color appears between the eyebrows and lacks luster, the pathology is in the skin; if the lips show blue, yellow, red, white, or black colors, the pathology is in the flesh; if the skin is sweaty and moist, the pathology is in the blood and Qi; if the eyes show blue, yellow, red, white, or black colors, the pathology is in the tendons; if the ear edges are dry and dark, with grime, the pathology is in the bones.

Huangdi asked: What are the manifestations and changes in disease conditions, and how should they be treated?

Bergao explained: Disease changes are manifold. The skin has sections, the flesh has columns, the blood and Qi have pathways, and the bones have associations. The pathology of the skin lies in the superficial areas of the limbs; the flesh columns are in the upper arms, lower legs, and the muscle ridges of the six Yang meridians and thick muscles along the Kidney Meridian of Foot Shaoyin; the pathways of blood and Qi are in the collaterals of each meridian, where they swell when stagnated; tendon pathologies are neither Yin nor Yang, neither left nor right, and treatment should follow the affected areas; bone pathologies are in the joints, and the acupoints that infuse essence fluid and nourish the brain marrow.

Huangdi asked: How should treatment be conducted?

Bergao advised: Given the myriad causes of diseases, acupuncture treatment must be either deep or shallow, superficial or profound. The primary principle is to base needling on the affected area and disease severity: shallow needling for mild diseases, deep needling for severe diseases, fewer needles for mild diseases, and more needles for severe diseases. Only a skilled doctor can adjust the Qi of the meridians based on disease changes and treat effectively.

Huangdi asked: How should one differentiate between the body types, sizes, cold and warmth of the body surface, and age categories?

Bergao clarified: People over fifty are considered old, those over thirty as middle-aged, those under eighteen as young, and those over six as small.

Huangdi asked: What criteria should be used to evaluate body fat and thinness?

Bergao explained: The body types are categorized as having fat (Zhi), oily (Gao), or muscular (Rou) compositions.

Huangdi asked: How should one distinguish between these three types?

Bergao responded: Those with thick, solid muscles and full skin are considered as having fat (Zhi); those with less solid muscles and loose skin as oily (Gao); those with skin closely connected to the muscles are considered muscular (Rou).

Huangdi queried: How does one differentiate the body’s cold and warmth?

Bergao explained: People with an oily (Gao) composition tend to have moist muscles. If the skin is coarse, Wei Qi easily leaks, leading to a cold body. If the skin is delicate, Wei Qi is easily retained, leading to a warm body. Those with a fat (Zhi) composition have solid muscles; if the skin is dense, the body is warm; if the skin is coarse, the body is cold.

Huangdi asked: How does one differentiate body fat and thinness?

Bergao replied: People with an oily (Gao) composition usually have abundant Yang Qi, loose skin, and soft, sagging abdominal muscles; those with a muscular (Rou) composition have broad bodies; those with a fat (Zhi) composition have solid muscles and smaller builds.

Huangdi inquired: How do the Qi and blood conditions vary among these three types?

Bergao elaborated: People with an oily (Gao) composition have abundant Yang Qi and warm bodies, making them resistant to cold; those with a muscular (Rou) composition have abundant Yin blood, nourishing muscles and bodies, with a balanced temperament; those with a fat (Zhi) composition have thin blood and slick Qi, with smaller bodies. These general conditions of Qi and blood vary from common people.

Huangdi asked: What are the conditions of ordinary people?

Bergao stated: Ordinary people have balanced skin, flesh, fat, and oil, maintaining a balance of blood and Qi without excess, resulting in proportionate bodies. This is the typical condition of ordinary people.

Huangdi praised Bergao and asked: How should diseases be treated for these three body types?

Bergao concluded: It’s crucial to distinguish the differences in Qi and blood among these three types, and the clarity or turbidity of Qi before treatment. Based on specific conditions, use regular methods for treatment. Therefore, people with an oily (Gao) composition have wide bodies and sagging abdominal muscles; those with a muscular (Rou) composition have broad bodies; those with a fat (Zhi) composition, despite having abundant fat, have small bodies.