Why treatment must vary with region: the classical argument for adapting method to place.
Su Wen (素问)Origins and Lineages
ENGLISH TRANSLATION
The English is translated from the Chinese vernacular. The original text and its pinyin sit beneath each sentence in smaller type; hide them whenever you prefer to read the translation alone.
The north is the region where heaven and earth close and store.
ORIGINAL北方者，天地所闭藏之域也。
běi fāng zhě，tiān dì suǒ bì cáng zhī yù yě。
The land is high and people dwell on the hills; wind and cold are bitter and ice is piercing. Its people delight in living in the open and live on milk, so their viscera grow cold and they suffer from distension; treatment suits burning with moxa.
ORIGINAL其地高陵居，风寒冰冽，其民乐野处而乳食，脏寒生满病，其治宜灸焫。
qí dì gāo líng jū，fēng hán bīng liè，qí mín lè yě chù ér rǔ shí，zàng hán shēng mǎn bìng，qí zhì yí jiǔ ruò。
Thus moxibustion also comes from the north.
ORIGINAL故灸焫者，亦从北方来。
gù jiǔ ruò zhě，yì cóng běi fāng lái。
The south is where heaven and earth nourish and rear, the region where yang is abundant.
The land lies low, water and earth are soft, and mist and dew gather there.
ORIGINAL其地下，水土弱，雾露之所聚也。
qí dì xià，shuǐ tǔ ruò，wù lù zhī suǒ jù yě。
Its people relish sour things and fermented food, so their skin is dense and their complexion red; they suffer from cramping and impediment, and treatment suits the fine needle.
ORIGINAL其民嗜酸而食胕，故其民皆致理而赤色，其病挛痹，其治宜微针。
qí mín shì suān ér shí fǔ，gù qí mín jiē zhì lǐ ér chì sè，qí bìng luán bì，qí zhì yí wēi zhēn。
Thus the nine needles also come from the south.
ORIGINAL故九针者，亦从南方来。
gù jiǔ zhēn zhě，yì cóng nán fāng lái。
Therefore the sage combines the methods in treatment, so that each is used where it suits.
ORIGINAL故圣人杂合以治，各得其所宜。
gù shèng rén zá hé yǐ zhì，gè dé qí suǒ yí。
Thus treatments differ and yet all illnesses are cured, because the true condition of the illness is grasped and the great principle of treatment is understood.
Yi Fa Fang Yi Lun explains that the same disease is treated differently in different regions because climate, diet and way of life produce different constitutions. The east, the west, the north and the south each receive a characteristic method.
For the history of acupuncture its importance lies in a single claim: the nine needles came from the south, and moxibustion from the north. This situates both techniques geographically and reminds the reader that they arose in different conditions and were not originally a single system. The chapter is the classical foundation of the principle of adapting treatment to place.
ANNOTATION
Moxa burning (灸焔): 焔 is pronounced ruò, to scorch; moxibustion by burning mugwort at the point.
Fu (胕): read as 腐, food that has fermented and ripened.
Dense texture (致理): skin and interstices firm and close.
Combine to treat (杂合以治): to use several methods together.
COMMENTARY
This chapter is often cited as the classic basis for adjusting treatment to time, place and person. Note that the ancients never compared methods in the abstract but always tied them to region, climate, diet and constitution. This has particular relevance for the international spread of Chinese medicine: the same prescription should be executed differently in Lingnan and beyond the northern passes.