Ling Shu Chapter 1

Ling Shu Chapter 1 is titled “The 9 needles and the 12 source points” wherein the source points are indicated as imperative to treat disorders of the Zang and the methods of tonification (“in slow, out fast”) and reducing (“in fast, out slow”) are explained. But I believe that the essence of the chapter lies in the following lines.

小鍼之要，易陳而難入，麤守形，上守神，神乎神，客在門，未睹其疾，惡知其原

The essentials of the small needles are easily explained but difficult to receive, the crude guard the form (the lesser physician only sees the body), the superior guard the Shen, Shen fantastic Shen, (without which the doctor is only a) guest at the gate and has not perceived the illness or known the origin of the evil.

刺之微在速遲，麤守關，上守機，機之動，不離其空，空中之機，清靜而微，其來不可逢，其往不可追。

The subtle and profound of needling are the rhythm (fastness and slowness), the crude physician guards the barrier (that which is closed), while the superior physician guards the movement of the mechanism, the mechanism is not separate from the void, the mechanism is the center of the void, it is quiet and subtle, you cannot meet it when it arrives, you cannot pursue it as it leaves.

知機之道者，不可掛以髮，不知機道，叩之不發，知其往來，要與之期，麤之闇乎，妙哉工獨有之。

To know the Dao of the mechanism, one cannot put up one's hair (be lazy), not knowing the way of the mechanism, you can knock (strike) the disease without emitting it, if you know its comings and goings, you can assist its phases, the dimness of the crude physician! the excellent physician alone has it.

往者為逆，來者為順，明知逆順，正行無問。

That which leaves is counterflow, that which arrives is flow, be fully aware of counterflow and flow, and you will have correct action without question.

逆而奪之，惡得無虛，追而濟之，惡得無實，迎之隨之，以意和之，鍼道畢矣。

Use it (the knowledge of the mechanism) to seize counterflow, get the evil without causing deficiency, pursue and assist it, get the evil without causing excess, welcome it and follow it, this means to harmonize it, this is the accomplished way of needling.

This is my favorite segment of this chapter of the Ling Shu because it explains the importance of engaging with the person’s Shen to observe disease but also of the disease process itself, the Bing Ji 病機, the pathological mechanism. This means that when we apply an acupuncture treatment, it isn’t enough to apply the rules of the body to find our treatment principles but we have to look at the process of the disease. For example, if someone has hemoptysis it isn’t enough to needle the points for hemoptysis. Rather we should seek an understanding of the root cause of the disorder and needle at the appropriate time, in the appropriate technique, to either “seize the counterflow to not create deficiency” or “follow it out to not cause excess.” “Not meeting it as it arrives and not pursuing it as it leaves” seems contradictory only if we operate from a fixed position. If we are firm in our beliefs and understandings of a disease, and thus remain metaphorically fixed in our ideas, we cannot be flexible and follow the ways of the disease which have a rhythm all of their own. It is this rhythm that is the key to unlocking the disease process.