This chapter is based on 《Ling Shu》Chapter 1, 3 and 9.
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The purpose of this Chapter is to discuss the meaning of Qi- arrival and the importance of it in acupuncture treatment. |
《靈樞九針上二原第一》
刺之而氣不至﹐無問其數﹔刺之而氣至﹐乃去之﹐勿復針…刺之要﹐氣至而有效﹐效之信﹐若風之吹雲﹐明乎若見蒼天﹐刺之道畢矣。
《Ling Shu Chapter 1》
One must continue to needle if “Qi-arrival” has not manifested and one must stop needling once “Qi-arrival” has occurred with attention to the prompt removal of the needle.
The crucial point of acupuncture technique is to get the “Qi-arrival” and the curative effect of acupuncture depends upon it. This notable curative effect may be described as if the wind blows away the clouds and the azure sky appears again.
《靈樞小針解第三》
“氣至而去之”者﹐言補瀉氣調而去之也。
《Ling Shu Chapter 3》
“Qi-arrival” refers to yin-yang balance. Following the successful application of reinforcing or reducing acupuncture techniques that balance the imbalanced yin or yang, is the time to remove the needle.
《靈樞終始篇第九》
凡刺之道﹐氣調而止﹐補陰瀉陽﹐音氣益彰﹐耳目聰明﹐反此者血氣不行。所謂氣至而有效者﹐瀉則益虛﹐虛者脈大如其故而不堅也﹐堅如其故者﹐適雖言快﹐病未去也。補則益實﹐實者脈大如其故而益堅也﹐夫如其故而不堅者﹐適雖言快﹐病未去也。故補則實﹐瀉則虛﹐痛雖不隨針減﹐病必衰去。
《Ling Shu Chapter 9》
Acupuncture is complete once “Qi-arrival” manifests. When the correct needling technique (reinforcing or reducing) is used to balance out the imbalanced yin or yang the result is for one to regain normal voice, hearing, and vision which reflect the normal and healthy functioning of the human body. It is necessary to stop the treatment otherwise one may cause Qi and blood stagnation which reflects a condition opposite to that of “Qi-arrival.”
It is said that the result of acupuncture is dependant upon “Qi-arrival”. With “Qi-arrival”, the strength of an excessive Renying or Cunkou pulse gets weaker following the reducing technique while the size of the pulse remains as large as it was before needling. And in contrast, with “Qi-arrival” a weak pulse of a deficient condition will get stronger while the size remains as small as it was before the reinforcing technique.
The disease may still be there if the strength of the pulse doesn’t change even if the acupuncture treatment leaves the patient feeling well.
Therefore, if the weakness of the pulse representing deficiency gets stronger following the reinforcing technique and the excessive strength of an excess pulse becomes reduced following the reducing technique, the treatment is proper, but the “pain” (meaning any and all symptoms) may not disappear at once even though the seriousness of an illness is lessened.
【Comment】
“Qi-arrival” is one of the crucial concepts of acupuncture technique, in 《Ling Shu Chapter 1 》and 《Ling Shu Chapter 9》, “Qi-arrival” and “Qi-harmony” have been used interchangeable which means these two words share the same meaning.
(1) What is meant by “Qi-arrival”? According to the《Ling Shu Chapter 3》: “Qi-arrival means yin/yang coming to balance following the application of reinforcing or reducing technique for the imbalance of yin or yang.” It is clear that “Qi-arrival” is a special medical term which represents the condition of yin/yang balance after applying the reinforcing and reducing technique for an imbalanced yin/yang.
Figure 5-8-1 The Meaning of Qi-arrival
(2) How does one clinically observe if there has been “Qi-arrival”? 《Ling Shu Chapter 9》explains that in order to determine if there has been “Qi-arrival” or not one can check the Renying and Cunkou pulses.《Su Wen Chapter 7》states “The pulse that represents three Yang Meridians is located at the head (Renying, carotid artery) while the pulse the represents three Yin Meridians is at the hand (Cunkou, radial artery). The Renying and Cunkou pulses of the same side of the body actually represent a Yin/Yang pair” Thus, in healthy people the strength of the Renying and Cunkou pulses should be even. And one may observe “Qi arrival” through Checking the Renying or Cunkou pulse after application of the reinforcing or reducing technique.
The crucial point of this method is to check for any change in the strength of those two pulses following treatment.
As stated above: “the strength of an excessive Renying or Cunkou pulse gets weaker following the reducing technique while the size of the pulse remains as large as it was before needling. And on the contrary, with “Qi-arrival”, a weak pulse of a deficient condition will get stronger while the size remains as small as it was before the reinforcing technique.”
Therefore, if the strength of the Renying and Cunkou pulses is observed to change towards a strength that is relative to each other, then “Qi-arrival” has been achieved.
For more information regarding this method please refer to Section1 “Renying and Cunkou Pulse”.
Figure 5-8-2 Observing “Qi-arrival” by Checking the Renying or Cunkou Pulse
There is another type of pulse diagnosis known as “three parts and nine portions of the pulse”; it is used to observe “Qi-arrival” during the treatment for dispelling pathological-Qi.
(3) What should an acupuncturist do after “Qi-arrival”? 《Ling Shu Chapter 1》states “One must remove the needle once “Qi-arrival” has appeared and stop further needling”.
This is because “Qi-arrival” indicates yin/yang balance, and any further needling will lead to a new imbalance of yin/yang, it may transmute a deficiency case into an excess case by over application of the reinforcing technique or transmute an excess case into a deficiency case by over application of the reducing technique.《Ling Shu Chapter 61》emphasizes that “one should avoid improper application of reinforcing or reducing techniques.”
“Qi-arrival” is the main purpose of acupuncture treatment, and it is not a matter of how long the treatment is taking or the number of acupoints that are applied; the most important principle of acupuncture technique is to achieve “Qi arrival.”
“One must persist with needling if ‘Qi-arrival’ has not appeared, and stop the treatment as soon as “Qi arrival” has been achieved. One must remember that once “Qi-arrival” has occurred the treatment is done, and also note that“ Qi arrival” should occur after each treatment and not after several different treatment times.
One may then question what to do in the event of “Qi-arrival” in a single treatment. Should the acupuncturist give the patient another treatment? Regarding this one will find answer in section 1 “The Pulse Diagnosis of Renying and Cunkou”.
(4) Unfortunately, generations of acupuncturists after Ling Shu ignore this clear statement of “Qi-arrival” in 《Ling Shu》Chapter 3 and 9, and misinterpret “Qi-arrival”. They divided the term “Qi-arrival” into “Qi” and “arrival”, taking “Qi” as a noun, and “arrival” as a verb, then “Qi arrival” becomes “Qi arrives under the needle”.
They created new methods to observe the phenomenon “Qi arrives under the needle”, by which the acupuncturist depends on the feeling they observe under the needle after insertion and the manipulation of the needle at the point.
This originated in the《Guide to Acupuncture Canon》 (AD 1312). In this classic acupuncture book, it says that “the light and slippery feeling under the needle indicates that Qi has not arrived, and if the feeling towards the top of the needle becomes tight and sinking; this indicates that Qi has arrived. And Qi arrival is described as the feeling under the needle as if a fish is caught on a hook, and the feeling that the Qi has not arrived is described to be empty as if a man is staying in an empty house. There is a favorable prognosis if the feeling under the needle, becomes tight, sinking, or there is the sensation as if the fish is caught on a hook that comes quickly after inserting the needle, and there is an unfavorable prognosis if those same observed needling experiences take time to manifest after inserting the needle.” (《標幽賦》﹕輕滑慢而未來﹐沉澀緊而已至…氣之至也﹐如魚吞鉤餌之浮沉﹔氣未至也﹐如閑處幽堂之深邃。氣速至而速效﹐氣遲至而不治。”) Most acupuncture books including textbooks contain this concept as the explanation regarding “Qi arrival”, and this is how it was taught in school.
《Ling Shu Chapter 1》states, “acupuncture curative effects depend on ‘Qi-arrival’”, all acupuncturists agree the importance of this statement. However, with this explanation described in the 《Guide to Acupuncture Canon》as a misunderstanding of “Qi-arrival”, acupuncturists have been looking for the feeling under the needle, instead of checking the Renying and Cunkou pulses, and this changed the evaluation method of acupuncture treatment from objective to subjective.
This kind of blind practice has also brought acupuncture techniques into a mysterious stage because the feelings observed under the needle could vary among various acupuncturists.
From then on, due to the misunderstanding of “De Qi”, the feeling of the patient after needling became another evaluation method in acupuncture treatment, and this has only lead to more confusion.
Figure 5-8-3 Comparison of “Qi-arrival” in 《Ling Shu》and in《Guide to Acupuncture Canon》
