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.The paragraph quoted above is followed by two such supplementations, Unschuld,Huang Di nei jing 12/2/02 1:34 PM Page 271survey of the contents of the su wen 271each representing a distinct historical layer.The first in the text, which wasnot necessarily the first to be written, states:{[namely] the minor yin and the major yang [conduits]}682The hand major yang and hand minor yin conduits form outer and in-ner; they are associated with the small intestine and the heart respectively.Su wen 41 advocates piercing right into the conduit to let blood. However,the context differs in that in Su wen 41, the foot major yang vessel lets a per-son s lower back ache, 683 and it is this very conduit where blood is to bedrained.It is difficult to determine whether the author of the first com-mentary quoted from Su wen 22 above had something similar in mind orwhether he suggested a qi manipulation by means of piercing a conduit as-sociated with the diseased organ.In contrast, the second commentary explicitly requests a piercing of{those [with] blood below the tongue}684thereby linking the treatment to bloodletting.Here it remains unclear, though,why those [with] blood below the tongue should be suitable for treating aheart disease.The hand major yang conduit does not touch the tongue atall.One branch of the hand minor yin conduit rises alongside the throat andends at the eye.One could think of the blood vessels below the tongue as linkedto this hand minor yin conduit branch and, therefore, to the heart; never-theless, a conceptual model explaining why bloodletting below the tonguecould be helpful in treating a disease in the heart is not offered in the presentcontext or anywhere else in the Su wen.The same applies to the remaining four diseases specified in Su wen 22.In each case, a list of ailments concludes with a recommendation to selectthe respective conduits, which is followed by two distinct commentaries,one advocating conduits associated with the diseased organ on the basis ofthe sixfold yin-yang categorization, the other pointing out those withblood. 10.3.Bloodletting to Treat QiVarious discourses in the Su wen link bloodletting and qi manipulation.Oneexample is Su wen 26:When heaven is warm and when the sun is bright,then the blood in man is rich in liquid,and the protective qi is at the surface.{Hence, the blood can be drained easily, and the qi can be made to move oneasily. Unschuld,Huang Di nei jing 12/2/02 1:34 PM Page 272272 survey of the contents of the su wenIt is therefore that one follows the seasons of heaven in regulating blood andqi.685Although genuine qi manipulation without bleeding eventually came todominate vessel therapy as its major objective, statements such as the onequoted above from Su wen 26 reveal at least a transitory stage of attempts atreconciling the two approaches to vessel therapy.Although no conceptuallink was established between bloodletting and qi manipulation, at least fora while the two were mentioned in one breath, as for instance in the followingexchange between Huang Di and Qi Bo in Su wen 27.[Huang] Di:Supplementation and draining, how are they carried out?Qi Bo:This is [done by] attacking the evil.Quickly remove [the needle] to remove abundant blood, andto have the [patient s] true qi return.This is, when an evil has just arrived as a visitor,it rong-rong [floats around] not occupying a definite location yet.If one pushes it, then it will move forward;if one pulls it, then it will stop.Move [the needle] against [its flow] and pierce it.Pierce to let the [patient s] blood, andhis disease comes to an end immediately.686The conceptual break in this short dialogue is quite obvious.It is obviousalso in Su wen 55, where cold and heat are identified as intruders that can beeliminated by bloodletting and where, a little further on, the author suggests:When piercing large [abscesses, let] much blood,in the case of small ones, lower [the needle] into the depth.687This recommendation is followed, once again a few lines further on, byan assertion that all the piercings mentioned earlier serve to guide the ab-dominal qi.When the heat has descended, [the disease] ends. Possibly thisstatement was added to justify ancient bloodletting in view of a modern the-ory of qi manipulation required for treatment.A different combination of bloodletting and qi manipulation is outlinedin Su wen 62.In this Discourse on Regulating the Conduits, five states ofsurplus and insufficiency are listed (i.e., of the spirit, the qi, the blood, thephysical appearance, and the will) that can be regulated by vessel therapy.To level a surplus spirit, drain blood from the small network [vessels]. 688To eliminate a surplus of blood, drain the respective conduits abounding[with blood], to let this blood. 689 When the will has [assumed a state of]surplus, then drain blood from the blazing sinews
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