《黄帝内经素问补注释文》Vol. 2

The Jia Yi Jing treats “Yin illness brings heat; Yang illness brings cold” as the main text. Though the wording differs, the meaning is the same.

When cold becomes excessive, it turns into heat; when heat becomes excessive, it turns into cold. When things reach an extreme, they change in the opposite direction. This is also like a blazing fire weakening a person’s healthy Qi, while a gentle fire strengthens it.

Cold damages the body, while heat damages Qi. When a cold pathogen invades, the movement of defensive Qi is obstructed, and the body is harmed. When a heat pathogen invades, nutritive Qi is depleted within the body, and Qi is harmed. Yin forms the body, while Yang transforms and generates Qi. But when cold or heat exceeds its normal bounds, both the body and Qi are seriously damaged.

Damage to Qi causes pain; damage to the body causes swelling. When Qi is damaged, heat becomes constrained between the muscles, causing pain. When the body is damaged, a cold pathogen invades the skin and interstitial spaces, causing swelling.

Pain followed by swelling means that Qi was damaged first, and the body afterward. Swelling followed by pain means that the body was damaged first, and Qi afterward. In other words, when signs of a Qi disorder appear first, followed by signs of a bodily disorder, this is called “Qi injuring the body”; when signs of a bodily disorder appear first, followed by signs of a Qi disorder, this is called “the body injuring Qi.”

When Wind becomes excessive, the body shows signs such as trembling and spasms. When the wind grows too strong, all things are shaken; this is also what the Zuo Tradition means by “wind excess causes disorders of the extremities.”

When Heat becomes excessive, the body swells. Heat causes Yang Qi to accumulate within the body, and swelling then arises suddenly. In severe cases, nutritive Qi becomes disordered and reverses its course, gathering between the muscular fibers and forming an abscess.

When Dryness becomes excessive, the body becomes dry because its fluids have been depleted.

When Cold becomes excessive, the body becomes edematous. Cold causes Yin Qi to congeal in the “mysterious portals” (the pores and interstitial spaces through which Qi and fluids enter and leave). Once these portals are blocked, Yang Qi builds up inside, producing edema.

When Dampness becomes excessive, it causes loose, watery diarrhea. Dampness invades the Spleen and Stomach; once they are affected, they can no longer properly transform food and drink. Water and grain become mixed together and pass out through the large intestine, producing diarrhea. Diarrhea caused by an excess of internal Dampness is called “damp diarrhea.” The Zuo Tradition’s phrase “rain excess causes abdominal illness” has a similar meaning.

The statements that Wind causes trembling, Heat causes swelling, Dryness causes dryness, Cold causes edema, and Dampness causes diarrhea also appear in the “Discourse on the Six Periods and Their Proper Order.”

Heaven has the four seasons and the Five Phases, which bring about the growth, development, gathering, and storage of all things, and give rise to changes such as cold, heat, dryness, dampness, and wind.

Spring is the season of growth and emergence, summer of flourishing, autumn of retraction, and winter of storage. This describes how the Qi of each season follows its own pattern of emergence, growth, retraction, and storage. Winter corresponds to Water and has a cold climate; summer corresponds to Fire and is hot; autumn corresponds to Metal and is dry; spring corresponds to Wood and is marked by prevailing winds; and late summer corresponds to Earth and is relatively damp. This describes the correspondence between the Five Phases and the five climatic influences: cold, heat, dryness, dampness, and wind. Although the influence of Earth is distributed across all the seasons, when we ask which season it governs, dampness belongs to the center. Thus, the Five Phases generate the five climatic influences of cold, heat, dryness, dampness, and wind.

The human five organs—liver, heart, spleen, lungs, and kidneys—can give rise to five emotional influences: joy, anger, sorrow, grief, and fear.

Here, the “five zang organs” are the liver, heart, spleen, lungs, and kidneys, and the “five influences” are joy, anger, sorrow, grief, and fear. When excessive, however, these five emotions can also damage the organs’ original state of harmonious Qi. The editor notes that the “Treatise on the Celestial Origins” writes “thought” where this passage has “sorrow.” Later in this chapter, anger is given as the emotion of the liver, joy of the heart, thought of the spleen, grief of the lungs, and fear of the kidneys; the “Treatise on the True Organs of the Jade Pivot,” by contrast, has “sorrow.” The chapters differ in their accounts. Huangfu Shian’s “Chapter on Spirit and the Five Zang Organs” in the Jia Yi Jing also discusses this matter. The text says “sorrow” because sorrow can restrain anger, using the mutual control among the five emotions as its framework. It says “thought” because thought is the emotion of the spleen. Taking either account alone cannot convey the full meaning; together, the two accounts complement each other and complete it.

Thus, joy and anger damage Qi, while cold and heat damage the physical form. Joy and anger arise from Qi, so they are said to injure Qi; cold and heat act directly on the body, so they are said to injure the form. This is broadly true when speaking in general terms and of what is nearest the surface. In finer detail, heat injures Qi, while cold injures the form.

Sudden anger injures Yin, and sudden joy injures Yang. When one becomes angry, Qi surges upward; when one rejoices, Qi moves downward. A sudden upward surge of Qi injures Yin, while a sudden downward movement injures Yang.

Rebellious Qi—the Qi that rises in a disordered way—surges upward and fills the channels and collaterals. This causes the spirit to become unanchored and drift away from the body.

When joy and anger lose their restraint, and cold and heat exceed their proper bounds, the foundation of human life becomes difficult to secure.

The Ling Shu Jing says: Those who understand how to preserve life follow the changes of the four seasons and adapt to cold and heat. They bring joy and anger into balance and keep their living environment stable. If joy and anger are erratic and cold and heat are out of balance, how can the original Qi bestowed at birth be preserved for long?

When Yin reaches its height, it turns into Yang; when Yang reaches its height, it turns into Yin. The same principle applies to injury from cold and heat.

Thus, if someone is injured by cold in winter, they will inevitably develop a warm disease in spring.

People may fall ill when assailed by the pathogenic influences of any of the four seasons. Cold is regarded as a toxic pathogen because it is especially forceful: once it enters the body, illness often follows at once. If illness does not appear immediately after exposure to cold, the pathogen may lie hidden between the skin and flesh. In spring it transforms into a warm disease, and in summer into a summer-heat disease. Those who preserve life must therefore take care to guard against pathogenic influences.

If someone is assailed by wind in spring, they will develop sunxie in summer—diarrhea in which food is expelled before it has been fully digested. When wind enters the body’s exterior, it affects the Liver within. Liver Qi then overacts on the Spleen, causing sunxie. The New Collation and Correction notes that the Treatise on the Generation of Qi and Connection with Heaven says: “When a person is assailed by wind in spring, if the pathogen remains lodged and does not leave, it becomes dongxie—unrelenting diarrhea.”

If someone is assailed by summer heat in summer, they will develop chenue—a malaria-like illness—in autumn. Summer heat is intense; by autumn, heat also gathers inward. These two sources of heat attack one another, giving rise to chenue. The text explains that “chen” means “thin,” referring to a kind of illness.

If someone is assailed by dampness in autumn, they will cough in winter. Dampness is prevalent in autumn, while Water Qi is strong in winter. Water and dampness combine, and Lung Qi is also relatively weak, so when the cold intensifies in winter, coughing is more likely. The New Collation and Correction notes that the Treatise on the Generation of Qi and Connection with Heaven says: “When a person is assailed by dampness in autumn, the pathogen counterflows upward and causes coughing, which then develops into weijue—a condition marked by withered weakness and coldness of the limbs.”

The Yellow Emperor said: I have heard that the sages of ancient times could explain the structure of the human body, distinguish the organs, and clarify the network of channels and vessels, linking them with the Six Directions—the four quarters above and below—and tracing their separate courses through their respective channels. Each point where channel Qi emerges has its own location and name. The hollows between the muscles connect with the bones, each with its own point of origin. The distribution of the body’s parts and the orderly or contrary movement of Qi and blood each have their own pattern. The four seasons and the changes of Yin and Yang also each follow their own laws; what lies within the body corresponds to what lies outside, with each having its paired exterior and interior. Are these teachings indeed so?

“Liuhe” refers to the six paired relationships formed by the twelve channels. The Ling Shu Jing says that Taiyin and Yangming form one pair, Shaoyin and Taiyang another, and Jueyin and Shaoyang a third. The hands and feet each have three channel pairs, so together they are called the “six pairings.” The Hand Jueyin Channel is the Pericardium Channel. The Qixue Lun says that places where large muscle masses come together are called “valleys,” and places where smaller masses meet are called “streams.” The boundaries between muscles, and the places where streams and valleys converge, are where nutritive Qi and defensive Qi circulate and meet with the great Qi. The places where the channels connect to the bones are called “bone attachments.” “Exterior and interior” means that all Yang channels belong to the exterior, while Yin channels belong to the interior. The New Collation adds that, in the passage beginning “The Emperor said, ‘Is this truly so?’” the Quan Yuanqi edition and the Taishu place it after “This was the teaching of the sages of high antiquity.”

Qibo replied: The East generates wind. Yang Qi rises and spreads out, becoming wind. Wind is the command of Heaven and the beginning of the transformation of all things; therefore, it is said to arise in the East.

Wind generates Wood. Wind stirs the trees and makes them grow luxuriantly; therefore, it is said that wind generates Wood.

Wood generates sourness. All things with a sour taste are generated by the Qi of Wood. The Hongfan chapter of the Book of Documents says, “Bending and straightening produce sourness,” meaning that things with the nature of Wood, able both to bend and to extend, produce a sour taste.

Sourness generates the liver. Here, “generates” means nourishes and promotes growth: sour foods first nourish the liver.

The liver generates the sinews. The liver’s essence and Qi can nourish the sinews.

The sinews generate the heart. The Book of Yin and Yang says, “Wood generates Fire.” The liver belongs to Wood. Its Qi first nourishes the sinews within the body, then generates and nourishes the heart, which belongs to Fire.

The liver governs the eyes. The liver corresponds to the eyes, which can see sunlight; this is connected with the liver’s function.

In Heaven, this is called “the Mysterious.” “The Mysterious” refers to the distant, profound hue of Heaven, not yet clearly revealed.

In the human being, this is called the Dao (the Way). Here, “Dao” refers to the transformation brought about by the Dao: people follow the Dao’s nurturing influence and return to its patterns.

On Earth, this is called transformation. “Transformation” refers to the creative process by which all things grow in season; their growth depends on it.

Transformation produces the five flavors. As all things grow, they acquire the five flavors, all brought forth through transformation and nurture.

The Dao generates wisdom. Wisdom arises from teachings that accord with the right path; therefore, it is said, “The Dao generates wisdom.”

The mysterious and profound give rise to Shen (spirit); hence the saying, “The mysterious gives birth to Shen.”

In Heaven, Shen manifests as wind, whose action is to soar, stir, and bend. Once it arises, it can blow far and wide, reaching everywhere. Only the wondrous transformations of Shen can do this.

On Earth, Shen manifests as wood. Softness, bending, and uprightness are qualities of wood.

In the human body, Shen manifests as the sinews. The sinews connect the body’s different parts and enable a person to exert strength.

Among the internal organs, Shen belongs to the Liver. The Shen stored in the Liver is the Hun (ethereal soul). The Meaning of the Daoist Scripture says, “The Hun resides in the Liver. When the Hun is at rest, a person does not stray from the Dao.”

In color, Shen manifests as cang, a pale blue-green like the color of wood.

Among the Five Tones, Shen manifests as the jue tone, the tone associated with wood: harmonious in sound and upright in quality. The Record of Music says, “When the jue tone is disordered, it makes people sorrowful, and resentment arises among the common people.”

In sound, Shen manifests as calling out, also known as whistling.

In the body’s movements and changes, Shen manifests as grasping: holding or pulling with the hands. The New Corrected Edition quotes Yang Shangshan: “Grasping, worry, shouting, coughing, and shivering are the five expressions that appear when the will is stirred; therefore they are called ‘movements and changes.’”

Among the body’s orifices, Shen manifests in the eyes, which distinguish forms and colors.

Among the Five Flavors, Shen manifests as sourness, which has a contracting effect.

In the emotions, Shen manifests as anger. Anger can stop improper conduct, but excessive anger can also harm the Liver.

Sorrow can restrain anger. Sorrow belongs to Metal in the Lung, while anger belongs to Wood in the Liver. Lung Metal restrains Liver Wood, so sorrow overcomes anger. The Treatise on the Qi of the Five Viscera, Clearly Revealed says, “When essence and Qi gather in the Lung, a person becomes sorrowful.” The New Corrected Edition explains that the five emotions are usually given as anger, joy, thought, worry, and fear. Here, “sorrow” is used in place of “worry”: unresolved melancholy harms the will, while sorrow that moves the heart harms the Hun.

Wind harms the sinews.

When wind Qi becomes excessive, it can tighten the sinews and vessels, making it difficult to bend and stretch. The Newly Collated Corrections says that, according to the Treatise on the Five Movements: “Wind damages the Liver.”

Dryness can restrain wind Qi because dryness belongs to Metal and wind belongs to Wood, and Metal overcomes Wood.

The statement that sourness harms the sinews means that eating too much sour food can damage them.

Pungency can restrain sourness because pungency belongs to Metal and sourness belongs to Wood, and Metal overcomes Wood.

Heat arises in the south because Yang Qi is abundant and intense, giving rise to heat.

Heat gives rise to fire. The methods of drilling wood to make fire and transferring a firebrand both show that fire comes from heat.

Fire gives rise to bitterness. Most bitter substances are generated through the transformative action of fire Qi. The Great Plan in the Book of Documents says: “Fire flames upward and produces bitterness.”

Bitterness corresponds to the Heart. Bitter substances mostly nourish the Heart first.

The Heart generates blood: this means that the Heart’s essence Qi can produce and nourish blood.

Blood generates the Spleen. The Book of Yin and Yang says, “Fire generates Earth.” The Heart belongs to Fire. After the Qi of Heart Fire nourishes blood within the body, it goes on to generate Spleen Earth. The Newly Collated Corrections notes that the Taishu has “vessels” where this text has “blood.”

The Heart governs the tongue. The Heart can distinguish right from wrong, while the tongue is used to express speech; therefore, the Heart and tongue are said to correspond.

Heat in the heavens is the natural Qi corresponding to the Heart. Intense summer heat is an expression of heat.

Fire on earth is the natural substance corresponding to the Heart. Fire burns upward and can cause things to gather together and be consumed. The word “zhe” is pronounced “ji.”

The body’s vessels are governed by the Heart. They carry nutritive Qi and defensive Qi—the Qi that nourishes and protects the body—and thereby nourish the blood.

Among the five viscera, the Heart stores Shen (spirit). According to the Meaning of the Dao Jing, Shen resides in the Heart. When Shen remains settled there, blood and Qi can flow freely.

Among the five colors, the Heart corresponds to red, since red symbolizes fire.

Among the five tones, the Heart corresponds to the zhi tone, which belongs to Fire and is harmonious and pleasing. The Record of Music says that when the zhi tone is disordered, it sounds sorrowful, and the affairs it corresponds to become burdensome. Among the five vocal sounds, the Heart also corresponds to laughter, the sound of joy.

The Heart’s changes manifest as worry. The Newly Collated Corrections cites Yang Shangshan: worry in the Heart is a change of the Heart, while worry in the Lung is an emotion of the Lung. The Lung governs autumn, and worry is its characteristic emotion. The Heart governs summer, and when the Heart’s Qi changes, it too can give rise to worry.

The tongue is the organ that distinguishes different flavors. The “Treatise on the True Words of the Golden Coffer” says: “The south corresponds to the color red, connects with the heart, and opens into the ear.” If we interpret this in terms of the body’s “openings,” the reference to the tongue here does not match the ear. But the tongue’s primary function is to distinguish flavors, so this passage says, “In the openings, it is the tongue.”

Among the five flavors, the heart corresponds to bitterness; among the emotions, it corresponds to joy. Bitter flavor dries dampness and promotes discharge, while joy brings harmony and cheerfulness. But excessive joy can also damage the heart.

Fear can restrain joy. When a person is afraid, the Qi of kidney water restrains heart fire and so overcomes joy. The “Treatise on the Five Qi Manifestations” says: “When essence and Qi gather in the kidneys, fear arises.”

Heat damages Qi, making the breath rapid. Cold can restrain heat because cold belongs to water Qi, and water overcomes fire.

Bitter flavor damages Qi because fire gives rise to bitterness. The annotator points out that this chapter describes several kinds of relationships between the five directions, the five flavors, and bodily harm: some harm is caused by a factor acting on itself, some by the Qi that it overcomes, and some by the Qi that overcomes it. The Great Simplicity (Taishu), however, interprets all these cases as harm caused by a factor acting on itself.

Salty flavor can restrain bitter flavor because saltiness belongs to water, which overcomes fire, while bitterness belongs to fire.

The Qi of the center gives rise to dampness. When Yang Qi is strong, it presses upward toward Yin Qi. Yin Qi condenses and rises; when the two meet, dampness forms. The Meaning of the Changes says that Yang Qi rises toward Yin Qi, which gathers it in; as it steams, rain forms. This shows that dampness arises when Yin Qi gathers and condenses. Citing Yang Shangshan’s explanation, the annotator says that in the sixth month, Yang and Yin Qi meet and steam together, producing dampness.

Dampness gives rise to earth. When earth absorbs dampness, it compacts and solidifies; this is why dampness is said to give rise to earth. Citing Yang Shangshan, the annotator says that the combined Qi of Yang and Yin forms dampness, which steams and transforms the myriad things, eventually turning them into earth.

Earth gives rise to sweetness.

All sweet-tasting things arise from the Qi of Earth. The Book of Documents (Shangshu), in “The Great Plan” (“Hongfan”), says: “Grain grows and produces sweetness.”

Sweetness nourishes the Spleen. All sweet-tasting things act first on the Spleen.

The Spleen nourishes the muscles. The Spleen’s vital essence enables the muscles to grow and sustains them.

The muscles nourish the Lungs. The Book of Yin and Yang (Yinyang shu) says: “Earth gives rise to Metal.” The Spleen belongs to Earth. After nourishing the muscles, the Qi of Spleen-Earth can in turn nourish the Lungs, which belong to Metal.

The Spleen governs the mouth. The Spleen receives water and grain (food and drink), while the mouth takes in the five flavors, so the Spleen corresponds to the mouth.

In Heaven, the Spleen corresponds to dampness; mist, dew, clouds, and rain are all expressions of dampness. On Earth, it corresponds to soil, whose nature is to be still and to grow grain. In the human body, it corresponds to the muscles, which surround the sinews and bones and give the body substance. Among the organs, it corresponds to the Spleen. The spirit stored by the Spleen is called “intention” (yi). The Meaning of the Dao Scripture (Daojing yi) says: “Intention resides in the Spleen; when intention is settled, wisdom does not become scattered.”

Among the five colors, the Spleen corresponds to yellow, the color of Earth. Among the five tones, it corresponds to the palace tone, which is broad and harmonious. The Record of Music (Yueji) says: “When the palace tone is out of tune, the state falls into disorder and the ruler becomes arrogant.” Among the five vocal sounds, the Spleen corresponds to singing, a sound of sighing.

In abnormal changes, the Spleen corresponds to shouting. Wang Bing interpreted “shouting” as “shouting with a belch,” saying that this sound is caused by cold in the Stomach. The Newly Corrected Edition (Xinjiao) argues that “belching” is not the same as “shouting,” while Yang Shangshan says that “shouting” is the sound of Qi surging upward in counterflow.

Among the body’s openings, the Spleen corresponds to the mouth, which takes in food and drink. Among the five flavors, it corresponds to sweetness, which has a soothing and gentle effect. Among the emotions, it corresponds to deliberation, which enables a person to consider the distant future.

Excessive deliberation can harm the Spleen. Anger can restrain deliberation, since an angry person often has no attention to spare for thinking. This also shows how anger acts upon thought.

Dampness can harm the muscles because the Spleen governs the muscles and dislikes dampness; when dampness is excessive, it injures them. Wind can restrain dampness because wind belongs to the Qi of Wood, and Wood overcomes Earth.

Sweetness can harm the muscles.

Sour flavor can restrain sweet flavor.

Sour belongs to Wood, and sweet belongs to Earth. According to the Five Phases cycle of conquest, Wood overcomes Earth, so sour can overcome sweet.

The West generates dryness.

The qi of the West is urgent and forceful; therefore, it generates dryness.

Dryness generates Metal.

Metal is hard and dry, and rings when struck. Thus it is said that dryness generates Metal.

Metal generates pungent flavor.

All pungent foods arise from Metal qi. The Book of Documents, in its “Great Plan” chapter, says, “From alteration comes pungency.” This means that Metal can yield and change its shape, and thus produces pungent flavor.

Pungent flavor generates the Lungs.

All pungent foods first grow within the Lungs.

The Lungs nourish the skin and hair.

The Lungs’ vital essence nourishes the skin and hair.

The skin and hair generate the Kidneys.

The Book of Yin and Yang says, “Metal generates Water.” The Lungs belong to Metal; their qi first nourishes the skin and hair, and then generates the Kidneys, which belong to Water.

The Lungs govern the nose.

The Lungs store qi, and the nose is the passage through which breath enters and leaves. Therefore, the Lungs govern the nose.

In Heaven, this corresponds to dryness.

Dryness is light and swift, forceful and strong; these are its effects.

On Earth, this corresponds to Metal.

Hardness and force, together with the ability to yield and change shape, are the qualities of Metal.

In the human body, this corresponds to the skin and hair.

The skin and hair cover and protect the body, guarding it against external influences.

Among the Five Zang organs, this corresponds to the Lungs.

The spirit stored in the Lungs is the Po. The Meaning of the Dao Scripture says, “The Po spirit resides in the Lungs. When the Po is settled, one can cultivate De and extend one’s lifespan.”

Among colors, this corresponds to white.

White symbolizes the color of Metal.

Among the Five Tones, this corresponds to the Shang tone.

Shang is the tone associated with Metal; its sound is clear and forceful. The Book of Rites, in its “Record of Music” chapter, says, “When the Shang tone is disordered, the state is thrown into confusion, and the offices responsible for government affairs fall into disarray.”

Among sounds, this corresponds to weeping.

Weeping is the sound of sorrow.

Among bodily changes, this corresponds to coughing.

Coughing helps clear and open the throat.

Among the bodily orifices, this corresponds to the nose.

The nose governs the sense of smell and breathing.

Among the Five Flavors, this corresponds to pungent flavor.

Pungent flavor has a dispersing and nourishing effect.

Among the emotions, this corresponds to worry.

Worry is deep and persistent thought.

Excessive worry harms the Lungs.

Joy can restrain worry. Joy belongs to the Fire of the Heart, which can control Metal in the Lungs; therefore, joy can overcome worry. The Plain Questions, in its “Treatise on the Five Zang Organs’ Qi” chapter, says, “When vital essence gathers in the Heart, joy arises.”

Heat damages the skin and body hair because it is produced by Fire and depletes the body’s fluids. Cold can restrain heat; this is Yin energy suppressing Yang energy.

An excess of pungent flavor damages the skin and body hair because eating too much of any one kind of food can cause harm. Bitter flavor can restrain pungent flavor: bitter belongs to Fire, and pungent belongs to Metal. According to the Five Phases theory of mutual overcoming, Fire overcomes Metal.

The North generates cold. Yin energy congeals and grows cold, thereby producing cold; when cold energy flourishes, it gathers and transforms into water. Salty flavor is produced by the energy of water. The “Great Plan” chapter of the Book of Documents says, “Moistening and descending produce saltiness.” This means that water is moistening and flows downward, thereby producing salty flavor.

Salty flavor enters the kidneys, so salty foods act first on the kidneys. The kidneys’ Jing and Qi nourish the bone marrow. Once the marrow is replenished, the Qi of Kidney Water can in turn generate and nourish Liver Wood, corresponding to the Five Phases relationship in which “Water generates Wood.” The kidneys govern the ears: they belong to the Water of the North, and, according to the account given here, sound enters through the ear orifices, so the kidneys correspond to the ears.

In nature, the kidneys correspond to cold; on earth, to water; in the human body, to bone; and among the five organs, to the kidneys themselves. The kidneys store resolve, and when the Qi of resolve is abundant, the bone marrow is full. Their corresponding color is black, the color of water; their corresponding musical note is Yu, a low, deep tone. The Book of Music says that when the Yu note is disordered, it sounds precarious and weak, and the sound itself fades. The corresponding vocalization is groaning; the corresponding bodily response is trembling, which may occur in severe cold or extreme fear; and the corresponding orifice is the ear.

The ears are used to distinguish the five notes. The “Newly Collated Text” says: According to the “Treatise on the True Words of the Golden Casket,” the ear openings belong to the “two yin openings” (the anterior and posterior openings). This passage says that the ears are linked to the Heart because the Heart’s Shen (spirit) and Qi reside in the ears; this differs from what was said earlier.

The salty flavor can soften and transform things.

In the Five Phases, the corresponding emotion is fear. Fear means being frightened or apprehensive.

When fear persists without abating, it affects the Kidneys from within and thereby harms them. The Ling Shu Jing says, “Fear that cannot be dispelled harms Jing (essence) and Qi.” This shows that fear does indeed affect the Kidneys.

Thought can restrain fear. By thinking deeply and considering what lies ahead, one can see how things came about and thereby overcome fear.

Cold harms the Blood. Cold causes the Blood to stagnate, making it more susceptible to damage. The “Newly Collated Text” says: In this passage, the Tai Su has “bones” instead of “Blood.”

Dryness can restrain cold. Dryness arises from heat and can therefore restrain cold. The “Newly Collated Text” says: In this passage, the Tai Su has “dampness” instead of “dryness.”

The salty flavor harms the Blood. Eating too much salt makes one thirsty, which shows that it harms the Blood. The “Newly Collated Text” says: In this passage, the Tai Su has “bones” instead of “Blood.”

The sweet flavor can restrain the salty flavor. Sweetness belongs to Earth, while saltiness belongs to Water, so sweetness can restrain saltiness. The “Newly Collated Text” says: From the point where Qibo begins replying to the Emperor’s questions up to here, the material is the same as in the “Treatise on the Five Circulations,” though the annotations in the two passages differ considerably and should be consulted together.

Thus it is said that Heaven and Earth are above and below all things. By observing how Heaven covers and Earth supports the myriad things, one can understand that they exist between Heaven and Earth.

Yin and Yang correspond to the Blood and Qi of human beings and to men and women: Yin governs Blood, Yang governs Qi; Yin Qi gives rise to women, and Yang Qi gives rise to men.

Left and right are the pathways through which Yin and Yang move. Yin and Yang Qi circulate back and forth within the human body, so left and right are called the roads along which Yin and Yang move. The “Newly Collated Text” says: The movement of Yin and Yang Qi is discussed in detail in the “Treatise on the Six Subtle Stages.” Yang Shangshan’s statement that “Yin Qi moves to the right, while Yang Qi moves to the left” refers to this passage.

Water and fire are the visible signs of Yin and Yang. By observing the Qi of water and fire, one can discern the signs of Yin and Yang.

Yin and Yang are the fundamental forces through which all things are generated and develop.

This refers to the fundamental role by which Yin and Yang depend on and promote one another, bringing all things into being and change.

Thus it is said: Yin is within, the foundation on which Yang acts; Yang is without, the force on which the movement of Yin Qi depends.

Yin is still, so it can guard Yang Qi. Yang is active, so it is regulated and driven by Yin Qi.

The Yellow Emperor asked, “How can we recognize an imbalance in which Yin or Yang is excessive?” Qibo replied, “When Yang Qi is excessive, the body becomes hot, the pores close, and breathing grows rapid and labored. The body cannot settle, bending forward and back. Sweat cannot emerge; there is fever, dry teeth, and vexation with a sense of oppression. If the abdomen is distended, the person is in danger of death. Such a person can endure winter but not summer.

“Because Yang Qi is excessive, the person can endure winter relatively well. But the heat is too intense, so summer cannot be endured.

“When Yin Qi is excessive, the body grows cold and sweats; it remains cold to the touch, and the person often trembles and feels chilled. If the cold becomes too severe, the hands and feet turn cold, Qi moves counter to its proper course, and the abdomen then becomes distended, putting life in danger. Here, ‘counterflow’ means Qi moving in reverse.

“Such a person can endure summer but not winter. Because Yin Qi is excessive, the person can endure summer relatively well. But the cold is too severe, so winter cannot be endured.”

These are pathological conditions caused by Yin and Yang becoming excessive in relation to one another.

The Yellow Emperor asked, “How can these two be brought into harmony?” Qibo replied, “Those who understand the ‘seven losses and eight gains’—an ancient teaching about the physiology of men and women and the regulation of sexual relations—can harmonize Yin and Yang. Those who do not know how to apply these principles will grow old before their time.”

Commentators explain that “use” here refers to sexual relations. In ancient thought, women were considered to reach the decline of Tiangui—a physiological substance associated with reproductive function—at forty-nine, or seven times seven, and men at sixty-four, or eight times eight. The “seven losses and eight gains” were interpreted as caring for the body and preserving Jing by following the different physiological characteristics of men and women. The “Treatise on the Heavenly Truth of High Antiquity” says that Tiangui arrives for women at around fourteen, when menstruation begins regularly, and for men at around sixteen, when Jing Qi becomes abundant. On this basis, commentators explain that women should avoid excessive depletion, while men should learn to restrain the loss of Jing Qi.

By the age of forty, Yin Qi naturally declines by half, and daily activity and routine also begin to diminish.

Inner depletion harms Yin Qi and exhausts the Yang Qi in the body’s center, so physical strength begins to decline. The Ling Shu Jing says: When people reach forty, the skin and its pores begin to loosen, their appearance gradually fades, and strands of gray appear in their hair. At this stage, people’s ability to manage their daily activities also begins to decline.

At fifty, the body grows heavy, and the ears and eyes become less keen.

This marks a gradual deepening of decline.

At sixty, the penis weakens, primordial Qi declines greatly, and the functions of the nine orifices—the body’s nine openings, including the ears, eyes, mouth, and nose—become impaired. The lower body grows weak while the upper body is relatively overactive, and mucus and tears often run from the nose and eyes.

This marks a more severe decline.

Thus it is said: Those who understand the way of cultivating life can keep their bodies strong; those who do not will grow old.

To “understand” here means to grasp the Seven Damages and Eight Benefits, an ancient term for methods of tending the body and restraining desire, and to understand how to preserve the body and nourish life.

People share the same desires, yet their outcomes differ.

“Same” means that all people have desires; “different” means that they ultimately show different states, growing either old and frail or strong and vigorous.

The wise observe what people have in common; the foolish look only at outward differences.

The wise see that although people share the same desires, they can still follow the way of cultivating life. The foolish see only that people’s appearances differ, and then begin imitating others. By cultivating life in accord with one’s nature, the Way of life grows ever more abundant; by blindly copying others, one’s methods of cultivation become inadequate. That is why the text below says “fang,” pronounced “fei liang.”

The foolish fall short in cultivating life; the wise have more than enough.

The wise follow the way of cultivating life from the outset, and so have an abundance; the foolish learn it only later, and so fall short.

With an abundance, one’s hearing and sight are keen, and the body is light and strong. The old can regain their vigor, while those in their prime can become even healthier.

Preserving one’s nature and caring for the body are the results of understanding the way of cultivating life. Thus it is said that the Dao cannot be left for even an instant; if it could be left, it would not be the true Dao. This is what the saying means.

Therefore, sages do nothing useless and are skilled at maintaining calm and simplicity. They follow their wishes and let their intentions unfold freely, while remaining in a state of emptiness, stillness, and freedom from desire. In this way, they live long lives and endure alongside Heaven and Earth. This is how sages care for the body.

Sages do nothing useless, so that they do not harm what is useful. They do nothing that injures their nature, but instead follow it; therefore, their lives are long, and they endure together with Heaven and Earth. The Zhuangzi, in the chapter “Gengsang Chu,” says: In matters of sound, color, and food, sages take what benefits their nature and discard what harms it. This is the way to preserve one’s nature. The Shang Shu says: “Do nothing useless, so that you do not harm what is useful.”

Heaven is deficient in the northwest, so the northwest belongs to Yin. The human body corresponds to Heaven, and therefore the right ear and right eye are less keen than the left ear and left eye.

The human body is situated below, and so it takes Heaven as its model.

The southeast of the Earth is lower, so the southeast belongs to Yang. The hands and feet on a person’s left side are also often less strong than those on the right.

Human beings are below, so they take the Earth as their model.

The Yellow Emperor asked, “Why is this so?” Qibo replied, “The East belongs to Yang. When the essence of Yang Qi gathers in the upper part of the body, it makes the upper part clear and leaves the lower part deficient. Thus hearing and sight are keen, while the hands and feet are less nimble. The West belongs to Yin. When the essence of Yin Qi gathers in the lower part of the body, it makes the lower part full and leaves the upper part deficient. Thus hearing and sight are less keen, while the hands and feet are nimble. Therefore, when a person is attacked by pathogenic influences in both upper and lower parts, the illness is more severe on the right when the pathogenic influence is in the upper part, and more severe on the left when it is in the lower part. These are places where the Yin and Yang of Heaven and Earth cannot fully provide for the body, so pathogenic influences take advantage of the deficiency and settle there.”

The correspondence between Yin and Yang and Heaven and Earth is like water in a vessel: if the vessel is round, the water takes a round shape; if it is curved, the water follows its curve. The same is true of a person’s blood and Qi: wherever there is a deficiency, pathogenic influences settle there.

Heaven has essence and Qi; Earth has form. Heaven has the Eight Principles, and Earth has the Five Paths. Yang belongs to Heaven and descends with essence and Qi to bring about transformation; Yin belongs to Earth and disperses harmonious Qi to form the myriad things. The Five Phases are the pathways by which the myriad things are nourished, and the Eight Winds are the guiding principles that bring about change. Here, “Eight Principles” refers to the winds from the eight directions, and “Five Paths” refers to the pathways through which the Five Phases generate and transform the myriad things.

Thus Heaven and Earth can be the parents of the myriad things. Yang Heaven transforms and gives rise to Qi; Yin Earth forms physical bodies. The Five Phases move, and the Eight Winds propel change, carrying the myriad things through processes such as storing and growing. The seasons proceed without disorder, so Heaven and Earth can bring about the transformation and nourishment of the myriad things.

Clear Yang Qi rises to Heaven, while turbid Yin Qi returns to Earth. Heaven and Earth can nourish and bring forth the myriad things precisely because of these movements of ascent and descent.

The movement and stillness of Heaven and Earth are governed by the guiding principles of Shenming—the power that presides over transformation between Heaven and Earth. In this way, the myriad things can pass through growth and storage in an endless cycle.

The wise follow Heaven above to nourish the head, take Earth below as their model to nourish the feet, and look to human affairs to nourish the five organs.

The head is round, so it corresponds to Heaven; the feet are square, so they resemble Earth. A person’s state of life changes, and the five viscera also change in turn, so care should be adapted to these changes.

The qi of Heaven connects with the lungs because the lungs are situated high in the body. The qi of Earth connects with “ya” because “ya” is located low down. The character “ya” is pronounced as in the fanqie spelling yi-xi.

Wind qi connects with the liver because wind can generate Wood. Thunder qi connects with the heart because thunder resembles Fire and makes a sound. Grain qi connects with the spleen because grains are hollow inside, while the spleen receives food. Rain qi connects with the kidneys because the kidneys govern water. The New Collation says that the Qianjin Fang records: “Wind qi corresponds to the liver; thunder qi stirs the heart; grain qi responds to the spleen; rain qi moistens the kidneys.”

The six channels are like rivers, because Qi and blood flow through them without pause. The intestines and stomach are like the sea, because they receive food and fluids. The Lingshu Jing says, “The stomach is the sea of water and grain.” The nine orifices are like channels where streams converge: when the nine orifices are clear, they are like water that is clear and bright; when the breath flows freely, it is like water continually in motion.

To compare the Yin-Yang of the human body with Heaven and Earth is to take Heaven and Earth as counterparts of Yin and Yang. Sweat that appears when Yang qi disperses can be compared to rain between Heaven and Earth: sweat leaves the body through the skin as Yang qi spreads outward, much as clouds rise and rain falls between Heaven and Earth. Thus it is called “the rain of Yang.” The movement and dispersal of Yang qi resemble the fierce winds between Heaven and Earth, so Yang qi is compared to fierce winds.

Violent wind resembles thunder, because it surges with force and makes a rumbling sound. Rebellious qi resembles Yang qi, because rebellious qi surges upward, and Yang qi also has an upward tendency.

Therefore, if treatment does not follow the guiding principles of Heaven’s seasons and take account of Earth’s patterns, calamity will follow.

When the laws governing Heaven’s movements and Earth’s patterns are violated, the Qi of the Six Channels becomes disordered, and the five kinds of Qi injure one another. Once the body’s true Qi is damaged, the disasters and illnesses that follow can be foreseen.

Evil wind arrives swiftly, like wind and rain. Here, “arrive” means that pathogenic Qi enters the body.

A skilled healer treats illness when the pathogen has only begun to arise and remains in the skin and hair. Next best is to treat it after it has appeared and entered the skin. After that comes treatment once it has reached the sinews and vessels. Only later is it treated in the Six Fu Organs, by which point the illness has become serious; treatment of the Five Zang Organs comes last. If treatment begins only after the pathogen has reached the Five Zang Organs, the patient is already on the threshold between life and death.

This is because the illness has by then taken shape. Shennong said that even after an illness has taken shape, there is still hope of recovery; but when it has only just formed, there is still a chance to cure it, whereas delay will damage the body. Thus, by the time the pathogen has entered the Five Zang Organs, the patient is already half alive and half dead.

Pathogenic influences from Heaven invade the body and damage the Five Zang Organs. The Qi of the four seasons and the irregular winds from the eight directions all belong to Heaven’s pathogenic influences. The “Treatise on the True Words of the Golden Coffer” says that winds from the eight directions bring pathogenic Qi, creating wind pathogens that invade the channels and afflict the Five Zang Organs, causing illness. Thus, pathogenic influences from Heaven damage the Five Zang Organs when they enter the body.

The cold and hot influences in food and drink invade the body and damage the Six Fu Organs: heat pathogens harm the stomach and bladder, while cold pathogens harm the intestines and the Qi of the gallbladder.

Dampness from the Earth invades the body and damages the skin, flesh, and sinews and vessels. Excessive dampness obstructs the movement of Nutritive and Defensive Qi, and therefore harms the skin, flesh, and sinews and vessels.

Those skilled in acupuncture can draw Yang from the Yin aspect and Yin from the Yang aspect; treat on the right to regulate the left, and on the left to regulate the right. They infer the patient’s condition from what they themselves understand, and the state within the body from what appears on its surface. They assess whether the illness is excessive or deficient, detect subtle changes, and identify deviations. In this way, they make no errors in acupuncture, because they understand the patterns of illness deeply.

Those skilled in diagnosis observe the complexion and feel the pulse, first distinguishing Yin and Yang. By discerning the Yang aspect, they can determine where the illness lies; by discerning the Yin aspect, they can infer its severity and when life or death may come. They then examine whether the complexion is clear or turbid, and thereby learn where the disorder is located.

This refers to observing the complexion, including the five colors: green, red, yellow, white, and black. “Regions” means the areas of the face that correspond to the internal organs and can be examined to assess illness.

By observing whether the breath is fast or slow, long or short, and by listening to the voice, one can learn where the patient is unwell. Listening to the voice means distinguishing the tones associated with the five notes, such as shang, jue, zhi, and yu. Observing the breath means noting its length.

By examining “weights, balances, compass, and square,” one can determine which part of the body a disease mainly affects. “Weight” refers to the counterweight of a scale, and “balance” to the marked beam; “compass” refers to a circle, and “square” to a right angle. These terms are used here to describe methods of diagnosis: the weight helps determine whether the disease is inside or outside the body; the balance, whether its location is high or low; the compass, whether the condition is gentle or deficient; and the square, whether it is excessive. The “Treatise on the Subtle Essentials of the Pulse” says that spring corresponds to the “compass,” signifying gentle Yang Qi; summer corresponds to the “square,” signifying flourishing Yang Qi; autumn corresponds to the “balance,” signifying that Yin rises and Yang descends, with Qi moving between high and low; and winter corresponds to the “weight,” signifying that Yang Qi is stored below. A skilled diagnostician uses these methods together. “What governs the illness” refers to the seasonal Qi associated with the disease, as well as whether its location is above, below, inside, or outside.

By examining the pulse at the cun and chi positions and observing whether it is floating, deep, slippery, or rough, one can determine where the illness originated and treat it accordingly. A floating pulse can be felt with light pressure; a deep pulse requires firmer pressure; a slippery pulse flows smoothly; and a rough pulse moves with difficulty. By carefully examining the cun and chi positions and distinguishing changes such as floating and deep, one can identify the cause and location of the illness and treat it. At this point, the “Classic of Acupuncture and Moxibustion” reads, “Know where the illness is, and treatment will then be without error.” In other words, if one first determines where the illness lies, treatment will not go astray.

During diagnosis, distinguish both the possibilities that may lead to error and those that will not, so that the condition targeted by treatment is correctly identified.

Thus, when an illness has just begun and is mild, acupuncture can relieve the pain. When the illness is at its height, one can wait for it to subside slightly before treating it. Attacking it while it is at its strongest may damage the body’s righteous Qi, so treatment should wait until the illness has weakened.

Therefore, when the illness is mild, follow its course and disperse it so that pathogenic Qi can leave the body. When it is severe, treatment should instead restrain and reduce it.

When the illness is severe, it should be expelled quickly.

As the illness subsides, support the upright Qi and bring its effects to light. Treat the illness after the pathogenic influence has weakened: once it recedes, the upright Qi can grow firm, and the complexion will appear bright and healthy.

When the Qi needed by the body is insufficient, replenish it with warming, nourishing Qi. When Jing is insufficient, replenish it through the flavors of food.

Here, “Qi” refers to defensive Qi, which circulates at the body’s surface, warms and nourishes the body, and guards against external pathogens. “Flavors” refers to the flavors each of the five zang organs requires. The Ling Shu Jing says that defensive Qi can warm the muscles, fill the skin, moisten the spaces between the skin and muscles, and govern the opening and closing of the pores. When defensive Qi is abundant, the body is therefore well warmed and nourished. The “Treatise on the True Nature of Antiquity” says that the kidneys govern Water, receiving and storing the Jing of the zang-fu organs. Only when the Jing of the five zang organs is abundant is there enough to distribute outward. Thus, when Jing is insufficient, the zang organs should be nourished with the flavors of food.

When a pathogenic influence is in the upper part of the body, follow its course and make it surge upward and be expelled. “Surge” means to raise and release it upward.

When a pathogenic influence is in the lower part of the body, guide it downward and discharge it. “Guide” means to direct it downward and drain it.

When there is distention and fullness inside the chest and abdomen, use purgative treatment within the body. Here, “within” means inside the abdomen.

If a pathogenic influence invades the body’s surface, induce sweating so it can be expelled with the sweat. Here, “pathogen” refers to Wind pathogen. When Wind pathogen invades the body’s surface, sweating can drive it out. “Zi” is pronounced “ci.”

If a pathogenic influence remains on the surface of the skin, disperse it by inducing sweating. Since the pathogen is on the exterior, sweating is used to disperse it.

If the Qi is urgent and forceful, press it down to contain and calm it. “Li” means urgent, and “han” means forceful and swift. When the Qi is urgent and fierce, pressing it down will contain and restrain it. “Li” is pronounced “biyao,” and “han” is pronounced “han.”

When a pathogenic influence is excessive, it should be dispersed and purged. If Yang Qi is excessive, disperse it; if Yin Qi is excessive, open its flow and purge it. Hence the following passage says:

Distinguish Yin and Yang to tell the soft from the firm. Yin is soft, and Yang is firm.

Treat a Yang illness through Yin, and a Yin illness through Yang. This is what is meant by guiding Yang through the Yin aspect and Yin through the Yang aspect. It also includes treating the left side through the right, and the right side through the left.

Determine the condition of the blood and Qi separately, so that each returns to its proper place. “Xiang” refers to the locations along the relevant channel where Qi and blood circulate.

When blood is excessive, pierce the vessels and let blood. Here, “ci” means piercing the blood vessels to release blood.

When Qi is deficient, draw and guide its movement so that it can be regulated.

The character “che” should be read as “dao,” meaning to guide or lead. Guided movement can help Qi flow smoothly.

The reviser says: According to the Jia Yi Jing, the character here is still written as “che.”

Huangdi Neijing Suwen Buzhu Shiwen, juan five.

The following are textual notes: In the main text, “ge” was originally written as “jiu”; it has been changed according to the Gu edition. “Cheng” was originally written as “ge”; it has been changed according to the Gu edition. “Ran” was originally written as “yan”; it has been changed according to the Gu edition. The two characters “gu qi” were missing from the original text and have been supplied from the Gu edition. The Gu edition has “bei shang” where the text reads “po dang.” “Sheng zhang” was originally written as “zhang sheng”; the character order has been adjusted according to the Gu edition. “Fu” was originally written as “shi”; it has been changed according to the Gu edition. The Gu edition has “zhuang” where the text reads “shou.” “Luo” was originally written as “ge”; it has been changed based on the meaning of the passage. The Gu edition has “che” where the text reads “chai.” “Ze” was originally written as “xun”; it has been changed according to the Gu edition. “Sheng” was originally written as “shang”; it has been changed according to the Gu edition. The character “cang” is absent from the Gu edition. The characters “fan” and “sheng” have been changed according to the Gu edition. “Sheng” was originally written as “xin”; it has been changed according to the Gu edition. “Shang” was originally written as “shang” with a different reading; it has been changed according to the Gu edition. The Gu edition has “jian” where the text reads “su.” The Gu edition has “zai” where the text reads “shen.” “Ning” was originally written as “cang”; it has been changed according to the Gu edition. The character “zhao” was missing from the original text and has been supplied from the Gu edition. “Zhi” was originally written as “zhi” with a different reading; it has been changed according to the Gu edition. The Gu edition has “fang” with a different reading where the text reads “fang.” “Zhi” was originally written as “shi”; it has been changed according to the Gu edition. The Gu edition has “jie” where the text reads “sui.” “Yu” was originally written as “gu”; it has been changed according to the Gu edition. The character “qi” was missing from the original text and has been supplied from the Gu edition.

The Yellow Emperor said: “I have heard that Heaven belongs to Yang and Earth to Yin; the sun belongs to Yang and the moon to Yin. The large and small months together amount to about three hundred and sixty days, forming a year. The human body follows the same pattern, with its internal workings governed by the cycles of the four seasons and the Five Phases. Thus, the human body too corresponds to Heaven and Earth. This account of Heaven, Earth, the sun, the moon, and the year is the same as what appears in the ‘Six Seasonal Nodes and the Manifestations of the Organs’ chapter.

“The Three Yin and Three Yang spoken of today do not seem to correspond to these Yin-Yang categories. Why is that?”

Qibo replied: “The transformations of Yin and Yang can be divided into ten, a hundred, a thousand, or even ten thousand kinds. If we continue to derive them, they become beyond counting. Yet their essential principle comes down to one.

“That principle is ‘separation and union’: Yin and Yang can separate, and they can come together. However countless their transformations may be, once you grasp the pattern of separation and union, you can understand their underlying principle.

“Heaven covers the Earth, and Earth bears all things, which thereby grow. What has not yet emerged from the ground is called the ‘Yin region,’ also known as ‘Yin within Yin.’ It lies in the Yin region, and its form has not yet appeared, so it belongs to Yin. Since Yin is within Yin, it is called ‘Yin within Yin.’

“What has emerged from the ground is called ‘Yang within Yin.’ It has become visible and begun to move, so it belongs to Yang. Since Yang Qi arises within Yin, it is called ‘Yang within Yin.’”

Yang bestows vital Qi on the myriad things, enabling them to begin growing. Yin governs and regulates this process within them, allowing their various forms to take shape. The character “yu” is pronounced “yu” and means “to give.”

Thus, the myriad things are born in spring, grow in summer, are gathered in autumn, and stored in winter. Spring and summer belong to Yang and govern birth and growth; autumn and winter belong to Yin and govern gathering and storage. If the natural order is disrupted—if spring cannot bring forth life, summer cannot sustain growth, autumn cannot gather things in, and winter cannot store them away—the Qi of the four seasons becomes blocked, and the Qi of Yin and Yang can no longer circulate.

Although the transformations of Yin and Yang are many, the principles by which they operate in the human body can be examined one by one.

The Yellow Emperor said, “I would like to hear how the Three Yin and Three Yang divide and unite.” Qibo replied, “When a sage stands facing south, the front is called ‘Guangming’ and the back ‘Taichong.’”

“Guangming” means broad and bright. The south belongs to Fire, where Yang Qi is abundant and bright, hence the name Guangming. The ancients held that sages faced the light as they governed the myriad things, and so they stood facing south. In the human body, the heart lies toward the front, so the front is called Guangming. The Chong Mai, an important vessel that runs through the whole body, lies toward the back; the Kidney Mai joins with the Chong Mai and grows strong, so the back is called Taichong.

The place where Taichong lies is called Shaoyin. This explains how the Kidney Mai and the Bladder Channel work together in an interior-exterior relationship.

Above Shaoyin is Taiyang. The kidneys belong to Yin, and the bladder belongs to Yang. Yin is below and Yang above; joined together, they form a pair of channel Qi. The Ling Shu Jing says that the Foot Shaoyin Channel is the Kidney Channel, which begins beneath the little toe and runs diagonally toward the sole of the foot. The Foot Taiyang Channel is the Bladder Channel, which passes along the Jinggu bone and reaches the outer side of the little toe. For this reason, above Shaoyin is called Taiyang.

The root of Taiyang begins at Zhiyin, the terminal acupoint of the Foot Taiyang Bladder Channel, and connects with the Gate of Destiny. It is called “Yang within Yin.”

“Zhi Yin” is the name of an acupuncture point located on the outer side of the little toe. “Mingmen” refers to the place where Jing and Qi gather, enabling all things to be seen; that is, the two eyes. The Taiyang meridian begins at the eyes and runs downward to the feet, so its root lies at the tips of the toes and is connected with the eyes. The Lingshu Jing says, “Mingmen is the eyes.” The meaning here accords with the Lingshu Jing. The Taiyang meridian occupies the position of the Shaoyin meridian, and is therefore called “Yang within Yin.” The editors of the revised text note that when the Suwen discusses the Taiyang meridian, it says “root” but not “knot,” while the Jiayi Jing gives a fuller account.

The part of the body above the middle is called “Guangming”; the part below Guangming is called “Taiyin.”

The Lingshu Jing says, “Heaven pertains to Yang and Earth to Yin; above the waist pertains to Heaven, and below the waist pertains to Earth.” Under this way of dividing the body, the part above the middle belongs to Guangming, while the part below the middle belongs to Taiyin. Another explanation is that the heart is the organ of Guangming, and the spleen below the heart is the organ of Taiyin.

The region in front of the Taiyin meridian is called “Yangming.”

Among the body’s meridians, the Stomach meridian belongs to Yangming and runs in front of the Spleen meridian. The Spleen meridian belongs to Taiyin and runs behind the Stomach meridian. The Lingshu Jing records that the Foot Taiyin Spleen meridian begins at the tip of the big toe, ascends along the boundary between the skin and flesh on its inner side, passes behind the bone at the base of the big toe, and then ascends in front of the inner ankle. The Foot Yangming Stomach meridian passes below the knee and runs downward into the foot. Thus, the meridian in front of the Taiyin meridian is called Yangming. In the passage below, the character chuai is pronounced “shi yuan.”

The Yangming meridian has Lidui as its root and is called “Yang within Yin.”

“Lidui” is the name of an acupuncture point located at the tip of the second toe. The Yangming meridian lies in front of the Taiyin meridian, and is therefore called “Yang within Yin.”

The region on the outer side of the Jueyin meridian is called “Shaoyang.”

Within the human body, the Foot Shaoyang channel of the Gallbladder runs along the outer side of the Liver channel, while the Foot Jueyin channel of the Liver runs along its inner side. The Jingmai chapter of the Lingshu Jing says: “The Foot Jueyin channel is the Liver channel. It begins at the tuft of hair beside the big toe and runs upward along the upper edge of the foot. The Foot Shaoyang channel is the Gallbladder channel. It runs along the top of the foot and reaches the tip of the fourth toe.” From this we can see that the outer side of the Foot Jueyin channel is the Foot Shaoyang channel. In the passage below, “fu” is pronounced “fu” with a different tone.

The root of the Foot Shaoyang channel begins at the Qiaoyin point, the Jing-Well point of the Foot Shaoyang Gallbladder channel, located at the tip of the fourth toe. It is therefore called “Shaoyang within Yin,” because Shaoyang lies on the outer side of Jueyin.

The distribution and functions of the three Yang channels can therefore be summarized as follows: Taiyang governs opening, Yangming governs closing and gathering, and Shaoyang governs the pivot, turning and rotation.

“Separate” refers to each channel carrying out its function on its own; “unite” refers to its coordination with a Yin channel. When functioning separately, each of the three Yang channels occupies its corresponding position. When coordinated, each is linked to the organs on the inner side. The terms “opening, closing, and pivoting” describe how the three Yang Qi differ in strength, movement, and function: “opening” governs the basis of Qi activity; “closing” governs gathering and containment; and “pivoting” governs subtle changes in the movement of Qi. Because the three Yang Qi have different effects, they have these three distinct functions.

The Xin Jiaozheng adds: The Jiuxu records that Taiyang governs the “gate,” Yangming governs “closing,” and Shaoyang governs the “pivot.” When the gate is impaired, the muscles and joints become lax and acute illness arises; therefore, the Taiyang channel can be selected when treating acute illness. When closing is impaired, Qi has nowhere to settle and palpitations occur; therefore, the Yangming channel can be selected for palpitations. When the pivot is impaired, the bones tremble and the body cannot stand steadily; therefore, the Shaoyang channel can be selected for trembling bones. The Jia Yi Jing gives the same account.

The pulses of the three Yang channels should not fall out of balance with one another. If their beats feel equally strong under the hand, with no difference in lightness or weight on superficial palpation, this is called “one Yang”: the three Yang Qi no longer show distinct differences in strength. “Bo” is pronounced with a changed tone.

The Yellow Emperor asked, “I would like to hear about the three Yin.” Qibo replied, “What is on the outside belongs to Yang; what is on the inside belongs to Yin.”

The Three Yang describe the movement, division, and convergence of Yang Qi on the body’s exterior; the Three Yin describe the activity, division, and convergence of Yin Qi within the body.

The middle region belongs to Yin. Its Chong Mai (one of the body’s important channels) lies below, so this region is called Taiyin. The Chong Mai is below the spleen, which is why it is said to lie in the lower position. The Lingshu Jing states that the Chong Mai and the collateral channel of Foot Shaoyin both arise below the kidneys and ascend through the Baozhong (the area where the uterus is located). Accordingly, the area above the Chong Mai is where Taiyin is situated.

The root of the Taiyin channel begins at Yinbai (a point on the Foot Taiyin Spleen Channel), so it is called “Yin within Yin.” Yinbai is at the tip of the big toe. Taiyin occupies a Yin position, hence the name “Yin within Yin.”

Below Taiyin comes Shaoyin; this refers to the positions of the organs and the order in which the channels run. Taiyin corresponds to the spleen, and Shaoyin to the kidneys; the kidneys lie lower and somewhat behind the spleen. The Lingshu Jing records that the Foot Taiyin Channel begins at the end of the big toe, runs upward along its inner side, passes in front of the inner ankle, and continues upward along the inner side of the shinbone. The Foot Shaoyin Channel begins below the little toe, runs obliquely toward the sole, passes below Rangu (the bony prominence on the inner side of the foot), and ascends behind the inner ankle. Thus, the region below Taiyin is called Shaoyin.

The root of the Shaoyin channel begins at Yongquan (a point on the Foot Shaoyin Kidney Channel), so it is called “Shaoyin within Yin.” Yongquan is in the hollow of the sole that appears when the toes are curled.

Before Shaoyin comes Jueyin; this, too, refers to the positions of the organs and the order in which the channels run. Shaoyin corresponds to the kidneys, and Jueyin to the liver; the liver lies above and in front of the kidneys. The Lingshu Jing records that the Foot Shaoyin Channel ascends behind the inner ankle and runs along the inner side of the lower leg. The Foot Jueyin Channel runs upward along the top of the foot, passes in front of the inner ankle, then ascends over the ankle and meets the Foot Taiyin Channel behind it. Thus, the region before Shaoyin is called Jueyin.

The root of the Jueyin channel begins at Dadun (a point on the Foot Jueyin Liver Channel). It is called “Yin’s utmost Yang,” meaning the place within Yin where Yin Qi is deepest and most extreme.

Dadun is the name of an acupuncture point located at the tip of the big toe, between the hairs of the three toes. The Yin channels on both sides of the foot converge here, so it is called “the utmost Yang of Yin.” Jue means “to reach an end”: Yin Qi reaches its limit here, which is why it is also called “the utmost Yin of Yin.”

The opening and closing relationship among the three Yin channels is therefore as follows: Greater Yin governs opening, Terminal Yin governs closing, and Lesser Yin governs the pivot.

This also shows that the Qi of the three Yin channels differs in each case. The New Collation cites the Jiuxu: when the function of the gate is impaired, the Spleen and Stomach cannot transport the essence of food and drink, and obstruction results; treatment should focus on the Greater Yin channel. When the function of closing is impaired, the Qi dynamic becomes slack and one is prone to sadness; treatment should focus on the Terminal Yin channel. When the function of the pivot is impaired, the pulse Qi becomes bound and impeded; treatment should focus on the Lesser Yin channel. The Jia Yi Jing gives the same account.

The functions of the three Yin channels cannot be separated from one another. When the pulse Qi beats without becoming stagnant, this is called “One Yin.”

Here, “sinking” refers to the pulse qualities of the three Yin channels appearing distinct from one another. The same is true when the pulse qualities of the Yang channels are floating. If the movement of channel Qi shows no clear distinction between sinking and floating, the three channels may be collectively called “the Qi of One Yin,” rather than treated as three Yin channels with separate functions.

Yin and Yang Qi move in alternation, accumulating and spreading through the body in a complete cycle. Qi moves both inside and outside the body, and each brings the other to completion.

“Surging” refers to Qi moving back and forth; “accumulating” refers to the pulse beating continuously; and “transmitting” refers to Yin and Yang Qi circulating and spreading. The pulse Qi moves without ceasing, gathering momentum as it flows; Qi and Blood circulate throughout the body, completing one cycle approximately every two water-clock intervals. Hence the phrase “accumulating and transmitting to complete one cycle.” Nutritive Qi and Defensive Qi move with the breath, circulating inside and outside the body to ward off external, deficient pathogenic influences. Each has its own role, and they also work together; hence Qi and the body bring one another to completion. The New Collation notes that another version writes “surging and surging” instead of “surging and moving.”

End of Volume Six of The Huangdi Neijing Suwen, Supplementary Annotations and Explanatory Text.

Volume Seven of The Huangdi Neijing Suwen, Supplementary Annotations and Explanatory Text.

The Yellow Emperor asked, “What is meant by the body’s ‘four channels’ and ‘twelve correspondences’?”

“Channels” refers to the meridians; “correspondences” means following and accompanying.

Qibo replied, “The four channels correspond to the four seasons, and the twelve correspondences to the twelve months. The twelve months, in turn, correspond to the twelve meridians.

“In spring, the pulse is wiry; in summer, surging; in autumn, floating; and in winter, deep. These are the pulse qualities of the meridians corresponding to the four seasons. ‘Correspondences’ means that the weather moves in succession through the twelve earthly branches, which represent directions and the order of time, and therefore corresponds to the twelve months. The months referred to here are Yin, Mao, and Chen in spring; Si, Wu, and Wei in summer; Shen, You, and Xu in autumn; and Hai, Zi, and Chou in winter. The twelve meridians are the three Yin and three Yang meridians in the hands and feet. They correspond to one another according to the number and movement of Qi, so they are discussed together.

“Pulses are divided into Yin and Yang. To understand the Yang pulses is to understand the Yin pulses; to understand the Yin pulses is to understand the Yang pulses.

“When Yin and Yang are understood deeply, their changes can be fully recognized.

“There are five kinds of Yang pulse, which combine to produce twenty-five variations. The ‘five Yangs’ here refer to the Yang Qi of the five viscera. Each of the five viscera corresponds to a season and has its own pulse quality; each pulse also contains the Yang Qi of all five viscera. When the five pulse qualities are matched with the five viscera, there are twenty-five variations. A textual commentator notes that this accords with the statement in ‘The True Viscera Pulses of the Jade Pivot’ that ‘illness in the five viscera has five kinds of change, making twenty-five variations in all.’

“Yin here refers to the true visceral pulses, abnormal pulses that appear when the Qi of the five viscera is failing. Once a true visceral pulse appears, it shows that the visceral Qi is declining. When the visceral Qi has failed, death is inevitable.

“The five viscera belong to Yin, so the true visceral pulses are called ‘Yin.’ When the liver pulse appears, the pulse is tight both inside and out, like touching a blade, and rough and taut like pressing a string. When the heart pulse appears, it is hard and forceful, like touching a young shoot, with successive beats that do not stop. When the lung pulse appears, it is large and hollow, like a feather brushing the skin. When the kidney pulse appears, it beats forcefully but then suddenly breaks off, like a finger striking a stone with a sharp tap. When the spleen pulse appears, it is weak and alternates between fast and slow. All these pulse qualities mean that the viscera are failing and the spirit Qi is dispersing; death is therefore certain.”

“Yang” here refers to the Yang Qi expressed by the Stomach.

“Yang of the Stomach” means the pulse at the Renying point, where the artery beats on either side of the throat. By observing whether the pulse is still or active, weak or strong, and whether it corresponds with the Qikou pulse, one can determine where the illness lies. The Stomach is where food and drink gather, so examining pulse signs associated with Stomach Qi can reveal the location of an illness. The Renying pulse lies on either side of the throat and can be felt when it beats. In general, the pulse on the left is smaller and can be used to examine the Zang organs; the pulse on the right is larger and can be used to examine the Fu organs. Another interpretation takes this to mean “the Yang of the Stomach womb,” but that is incorrect.

Distinguishing the Yang pulses reveals where an illness is located; distinguishing the Yin pulses can indicate whether it will end in life or death.

Yang Qi protects the body’s exterior and wards off external pathogens. When an external pathogen invades, examining the Yang pulses can show where the illness lies. Yin Qi stores and nourishes the spirit and maintains the body’s interior. Assessing whether Yin Qi is sufficient and whether the pulse is failing can indicate the illness’s likely outcome. The Xin Jiao Zheng points out that the Treatise on the Jade Mechanism and True Viscera reads: “Distinguish the Yang, and you will know where illness comes from; distinguish the Yin, and you will know the time of life and death.” In other words, examining the Yang pulses reveals where and how an illness began; examining the Yin pulses can indicate when life or death will come.

The three Yang pulses are at the head, and the three Yin pulses are in the hands. This means that Yin and Yang join and the pulses correspond with one another.

“Head” here refers to the Renying pulse, and “hand” to the Qikou pulse, located near the wrist, one cun behind the thenar eminence. When the two pulses respond to each other, arrive and recede in unison, and are equal in size, the person is called “healthy”: the pulse is balanced and shows no clear signs of illness. This is why the two are said to “unite as one.” The Renying point lies about one and a half cun on either side of the throat. Both Renying and Qikou can be used to examine Qi in the Zang-Fu organs.

Examining the Yang pulses can reveal when an illness will arise or worsen; examining the Yin pulses can indicate its likely outcome.

If one can recognize changes in Qi and determine when an illness began, one can identify the days on which it is especially important to observe the illness’s prohibitions. By carefully examining whether the illness is gaining or losing ground, one can infer whether it will end in life or death.

Master the changes of Yin and Yang carefully, and there is no need to follow the crowd in deliberation.

By carefully assessing changes in pulse Qi and becoming familiar with the patterns of Yin and Yang, one can know when an illness will arise and change, and gradually judge questions of life and death. If one examines the patient according to these principles, one will not be confused and need not rely on others’ opinions.

The Yin and Yang described here are distinguished through changes in the pulse: receding pulse Qi is Yin, and arriving pulse Qi is Yang; stillness is Yin, and movement is Yang; slowness is Yin, and speed is Yang. This passage describes Yin and Yang as they appear in the movement of the pulse.

When examining a true-organ pulse—a pulse that appears when the essence and Qi of the organs and bowels are failing—if it becomes so rapid that it seems close to stopping, the following time limits apply: when the liver pulse appears, death follows after eighteen days; when the heart pulse appears, after nine days; when the lung pulse appears, after twelve days; when the kidney pulse appears, after seven days; and when the spleen pulse appears, after four days.

A “true-organ pulse” is the pulse that becomes evident when disease of the organs and bowels is severe. The classic explains these time limits through the generating and overcoming relations of the Five Phases and numerical correspondences: the liver belongs to Wood, and eighteen days draws on the numbers for Metal and Wood; the heart belongs to Fire, and nine days draws on those for Water and Fire; the lungs belong to Metal, and twelve days draws on those for Metal and Fire; the kidneys belong to Water, and seven days draws on those for Water and Earth; the spleen belongs to Earth, and four days draws on the number for Wood. Thus, the “Treatise on the Appearance of Qi in the Healthy Person” says that liver disease accompanied by a Geng or Xin day, heart disease by a Ren or Gui day, lung disease by a Bing or Ding day, kidney disease by a Wu or Ji day, and spleen disease by a Jia or Yi day portends death. This means that when illness progresses to the corresponding day, the organ dies because it cannot withstand the Qi that overcomes it.

The statement “illness of the two Yang channels affects the heart and spleen” means that disease in the Yangming channels, which include the stomach and large intestine, can affect the heart and spleen. The patient may have difficulty engaging in sexual relations; women may stop menstruating.

Commentators explain that illness of the stomach and intestines can affect the heart and spleen. When the heart is affected, the flow of blood becomes impeded; when the spleen is affected, food is not properly digested and absorbed. Impeded blood flow may cause women to stop menstruating, while food that cannot transform into essence and Qi may result in reduced seminal essence in men, which can also affect sexual relations. The “Treatise on the Correspondences of Yin and Yang” says that when essence and Qi are deficient, they should be nourished through food. If food cannot transform into essence and Qi, these will diminish. The “Treatise on Strange Diseases” says that the womb—the uterus and related structures involved in pregnancy—is connected to the kidneys. The “Treatise on Heat Disorders” also says that when the uterine vessels are obstructed and Qi counterflows upward, heart Qi cannot descend and flow freely, which may likewise stop menstruation. The “Treatise on the Primordial Truth of Antiquity” says that around the age of fourteen, a girl’s Tiangui—the subtle substance that promotes reproductive development—arrives, the Ren vessel opens, and the Taichong vessel fills, allowing menstruation to come regularly. Around the age of sixteen, a boy’s Tiangui arrives, and his essence and Qi become sufficient for emission. Thus, this kind of illness may appear as stopped menstruation in women and reduced seminal essence in men.

If the illness progresses further, it may develop into “wind wasting,” a disorder marked by emaciation and the decline of Qi and blood, or “resting mass,” a disorder marked by congested and counterflowing lung Qi and rapid breathing. At this stage, it is a critical illness that is difficult to treat.

When pathogenic illness penetrates deep into the stomach and remains uncured for a long time, it spreads to the spleen, causing wind-heat and gradual emaciation. When disease in the large intestine becomes severe and the pathogenic influence enters the lungs, it causes wheezing, with rapid breathing that surges upward. Illness in the intestines, stomach, spleen, and lungs then involves the heart. The five zang organs and six fu organs restrain and injure one another, making the condition critical and difficult to treat. The character “ze” is read as “ben.”

When the Three Yang channels—the Hand Taiyang Small Intestine channel, Hand Yangming Large Intestine channel, and Foot Taiyang Bladder channel—are diseased, alternating chills and fever may occur. When the illness is located in the lower body, symptoms may include paralysis with swelling, weakness and wasting, cold reversal, and sores. The Small Intestine channel travels up the arm, around the shoulder, and to the head. The Bladder channel descends from the head along the back, passing over the buttocks and down the backs of the legs. Thus, illness in the upper body causes chills and fever, while illness in the lower body may cause swelling, sores, weakness and wasting of the muscles and sinews, and Qi counterflow. “Pain” here means soreness; “wasting” means weakness; and “reversal” refers to cold feet as well as Qi rising counter to its normal course.

As the pathogenic influence continues to transform, the skin loses its luster and moisture. When heat becomes excessive, Jing and blood are depleted, and the Qi that moistens the skin is also consumed. Yang Qi sinks downward while Yin Qi rises in opposition: the upward reversal of Yin Qi increases signs of cold, while the sinking of Yang Qi slackens the sinews and vessels. The testicles then descend and become lax, with an internal drooping hernia—a type of hernia—also forming.

When a One Yang channel—the Shaoyang Gallbladder channel and Triple Burner channel—is diseased, the person may become short of breath, cough easily, and be prone to diarrhea. Gallbladder Qi affects stomach Qi, making diarrhea more likely; illness within the Triple Burner causes shortness of breath; and Yang Qi disturbing the lungs leads to coughing. The illness described here is associated with an internal response to Heart Fire.

As the pathogenic influence continues to transform, a tugging discomfort may arise in the heart, and the diaphragm may become obstructed. Qi from the diaphragm disturbing the heart causes Heart heat to draw Yang Qi inward, where it becomes bound and uncomfortable. When the Triple Burner is internally congested and heat is obstructed, the diaphragm becomes blocked. “Tugging” means pulling or drawing.

When the Two Yang and One Yin channels—the Yangming and Jueyin channels—are diseased, the main symptoms are fright and fear, back pain, and frequent belching and yawning. This condition is called “Wind Reversal.”

“One Yin” refers to the pulse of the Heart Ruler in the Jueyin channel (the Pericardium channel of Hand Jueyin) and the pulse of the Liver. The Heart Ruler’s pulse begins in the chest and belongs to the Heart. The classic says that Heart disease causes pain in the front of the chest, the back, and between the shoulder blades. When the Heart Qi is out of balance, belching also occurs, so there is back pain and frequent belching. When Heart Qi is deficient, Kidney Qi takes advantage of the weakness and rises upward. The Liver governs fear, so there is fright and frequent yawning. Liver Qi belongs to Wind; when Kidney Qi surges upward in counterflow, pathogenic Wind combines with the rebellious Qi. This is therefore called “Wind Reversal.”

When “Two Yin and One Yang” become diseased, there is often abdominal distension, fullness and oppression in the chest, and frequent sighing.

“Two Yin” refers to the pulses of the Heart and Kidney in the Shaoyin channel. The Qi of the Kidneys and Gallbladder becomes disordered in counterflow, and the Triple Burner (the organ system that regulates Qi throughout the body and the movement of fluids) becomes obstructed. Qi therefore accumulates in the upper part of the body, causing fullness and oppression in the chest. The lower part is weak while Qi is abundant above, so Qi escapes outward.

When “Three Yang and Three Yin” become diseased, one side of the body may become withered and weak, the limbs may become limp and powerless, or their function may change, leaving the limbs unable to move.

Insufficiency of the Three Yin leads to withering and weakness on one side of the body. An excess of the Three Yang causes limpness and weakness. “Change” means that the limbs can no longer move as they normally do: their function has altered.

A pulse that beats like a hook is called “hook-like”; one that beats like a hair is called “hair-like.” When Yang Qi beats strongly and rapidly, the pulse feels like a taut string and is called “wiry.” When the pulse seems to break off as Yang Qi arrives, it is called “stone-like.” When Yin and Yang Qi move back and forth together, the pulse flows like water and is called “flowing.”

This explains how to recognize Yin and Yang disorders from the pulse. When “One Yang beats,” the pulse appears hook-like. Why is this? One Yang refers to the Triple Burner, the bowel associated with the Heart’s pulse Qi. When the Qi of the Triple Burner beats, the hook-like pulse appears; this is the pulse of the Heart. This describes the normal presentation of the pulse.

“One Yin” refers to Jueyin, the Qi of Liver Wood. “Hair-like” is the pulse of the Lung. Metal Qi comes to restrain Wood Qi, and the pulse then takes on a hair-like quality. If Metal Qi intrudes while Wood Qi remains strong, the pulse becomes urgent and wiry. When Yang Qi arrives and the pulse is urgent, it is called wiry and belongs to the Liver. When Yang Qi arrives and the pulse seems to break off, it is called stone-like and belongs to the Kidneys. When Yin and Yang Qi intermingle and move back and forth without either prevailing, the pulse is like flowing water.

Yin Qi struggles in disorder within, while Yang Qi stirs outside. Sweat pours out and cannot be contained. The limbs become cold and the condition rises upward in attacks. After an attack, the pathogenic influence focuses on the Lungs, causing panting and a rattling sound in the throat.

If agitation continues without pause, like the beating of metal drums, Yang Qi will become excessive, and Yin and Yang Qi will struggle against each other. They will contend within and disturb the body from without, so that sweating becomes unstoppable while the hands and feet grow cold. In severe cases, Yang Qi churns chaotically within the body, and sweat pours out in great quantities without being contained. Heat pathogens then invade the lungs, causing panting and audible breathing when one rises.

The generation of Yin depends on harmony as its foundation. Only when its foundation is in harmony can it be called “harmonious.”

Here, “Yin” refers to the Five Spirit Organs—the five organs that store Jing and Qi and settle the mind and spirit. The five organs can nurture life and preserve natural harmony because each follows its own nature and remains stable. If they depart from what is appropriate, other pathogenic forces can exploit the opening and invade, giving rise to all kinds of illness. How, then, could the way of nourishing life be treated without care?

Thus, when strength is met with strength, Yang Qi collapses and Yin Qi perishes.

Here, “strength” refers to Yang Qi. Yang Qi steams within the body and manifests outwardly as perspiration. If intense heat continues without ceasing, Yang grows ever more excessive. Such excess cannot last: Yang Qi will eventually exhaust itself. Once Yang Qi is damaged, Yin Qi cannot exist on its own; when Yang collapses, Yin perishes with it. This is how striving to overpower others and claim victory instead brings defeat and ruin.

When Yin and Yang Qi become obstructed and stagnant, and strength and softness lose their harmony, the Qi in the meridians will be cut off.

People whose blood is thick often have an excess of Yang Qi. When this is observed, their Qi should be harmonized with care so that its movement remains free. If they fail to reflect deeply and moderate their desires, the movement of Qi will become disordered and gradually decline. Yang Qi will then become excessive, and the organs will be harmed. Death will soon follow. How could life last long?

In a condition belonging to “dead Yin,” a person will die within three days.

This is a case of Fire overcoming Metal, according to the Five Phases cycle of overcoming.

In a condition belonging to “living Yang,” a person will die within four days.

This is a case of Wood overcoming Fire. The New Collation notes that the Quan Yuanqi commentary reads “on the fourth day, it is over” instead of “on the fourth day, one recovers.” Both readings make sense. In light of the surrounding text, rendering the phrase as “die on the fourth day” is inappropriate.

The terms “living Yang” and “dead Yin” refer to the transmission of Liver Qi to the Heart, which is called “living Yang”:

This is the transmission of the mother Qi to the child Qi, hence the name “living Yang.” This reflects not only the Five Phases relationship of Wood generating Fire, but also the fact that Yang governs growth and emergence.

The transmission of Heart Qi to the Lungs is called “dead Yin”:

Yin governs contraction and decline, and Fire overcomes Metal. When Metal is overcome by Fire, it is damaged; hence the name “dead Yin.”

The transmission of Lung Qi to the Kidneys is called “double Yin”:

This, too, is a transmission from parent to child. Since the Lungs and Kidneys both belong to Yin, it is called “double Yin.”

Disease arising between the kidneys and spleen is called pi yin, a condition that is difficult to treat. When Earth qi becomes excessive and accumulates, Water qi rises. This is what is meant by pi yin.

When Yang qi becomes congested, the limbs swell, because the limbs are the foundation of the Yang channels.

When Yin qi becomes congested, blood may appear in the stool, with the amount reaching as much as one sheng, because Yin governs blood. If the Yin congestion worsens once, the bleeding reaches two sheng; if it worsens again, it reaches three sheng. “Second congestion” means the illness has worsened to the second level, and “third congestion” means it has worsened to the third.

When Yin and Yang qi accumulate and become unbalanced, with more Yin qi and less Yang qi, the condition is called shi shui (“stone water”), and the lower abdomen swells. This results from Yin-Yang imbalance and a departure from the normal order.

“Two Yang bound” is called xiao (“wasting”). It refers to pathogenic heat congesting both the stomach and large intestine. When heat accumulates in the digestive tract, it readily consumes fluids and food.

“Three Yang bound” is called ge (“obstruction”). It refers to pathogenic heat congesting the small intestine and bladder. Heat accumulating in the small intestine dries the blood vessels, while heat in the bladder exhausts bodily fluids. This causes obstruction and makes it difficult to pass urine or stool.

“Three Yin bound” is called shui (“water”). It refers to cold pathogens congealing in the channels of the spleen and lungs. When cold congeals in the spleen and lungs, the movement and transformation of qi become disordered, and edema forms.

“One Yin and one Yang bound” is called hou bi, a disorder involving blockage, swelling, and pain in the throat. Here, “one Yin” refers to the channel of the Heart Governor, the Hand Jueyin Pericardium channel; “one Yang” refers to the Triple Burner channel, the Hand Shaoyang Triple Burner channel. Both channels connect with the throat. When heat in the qi becomes congested internally, hou bi develops. The character bi is read as “bi,” meaning “closed.”

A pronounced pulse at the wrist’s proximal position, differing from the pulse at the distal position, is called “Yin pulse beating distinctly from Yang” and is a sign of pregnancy. Here, “Yin” refers to the proximal pulse position, and “beating” means that the pulse can be felt clearly. A strong proximal pulse distinct from the distal pulse indicates Yang qi within Yin. Here, ren means pregnancy.

When both Yin and Yang are weak, the intestines may fail to restrain their contents, causing blood in the stool and potentially leading to death. Pi refers to a disorder affecting Yin qi. If stomach qi cannot be retained and the intestines become lax and incontinent, Yin qi can no longer contain them either. This shows that the true qi has been exhausted.

When Yang qi joins Yin qi, this is called “sweat.” Yang qi rises from below and combines with Yin qi in the upper part of the body; after being transformed by steaming, it becomes sweat.

When Yin is deficient and Yang qi strikes against it, this is called “collapse.”

When the Yin pulse is weak and the Yang pulse beats strongly, collapse and leakage occur within the body, and blood flows downward without stopping.

When all three Yin pulses show abnormal throbbing, death is expected after twenty days, at midnight.

This concerns the numbers of completion and remainder associated with the Spleen and Lungs. Here, “throbbing” means that the pulse is deep and sunken yet also forcefully pulsating, unlike a normal pulse. Yin Qi has reached its extreme, so death occurs at midnight.

When both Yin pulses show abnormal throbbing, death is expected after thirteen days, in the evening.

This concerns the numbers of completion associated with the Heart and Kidneys. Yin Qi has not yet reached its extreme, so death occurs in the evening.

When one Yin pulse shows abnormal throbbing, death is expected after ten days, during the day.

This concerns the numbers of generation associated with the Liver and Heart.

When all three Yang pulses show abnormal throbbing and the pulse force surges, death is expected after three days.

This is because Yang Qi is moving too rapidly.

When all three Yin pulses and all three Yang pulses show abnormal throbbing, there will be distension and fullness in the chest and abdomen. As the illness reaches its extreme, neither urination nor defecation can proceed normally, and death is expected after five days.

This is because Yin Qi, too, has become abnormal. “Hidden matters” refers to elimination, such as urination and defecation.

When both Yang pulses show abnormal throbbing, the movement of Qi becomes disordered and the illness is beyond treatment; death will come within ten days at most.

This concerns the king number associated with the intestines and stomach. The New Collation notes: on close examination, the text here seems to be missing a passage on “one Yang pulse throbbing.”

End of Volume Seven of Supplementary Annotations and Commentary on the Huangdi Neijing Suwen.

The Yellow Emperor asked, “I would like to understand how the body’s twelve organs and viscera work together. What are their respective roles and ranks?”

The “zang” spoken of here refers to the organs and viscera that store and circulate things within the abdomen. It does not mean that there are twelve separate bodily and spiritual repositories.

Qibo replied, “Your question is comprehensive. Allow me to explain each one in turn.

“The heart presides over the whole body like a sovereign, and Shen (spirit) arises from it. It governs the body’s activities, so it is called the ‘office of the sovereign.’ Because the heart remains still and clear and governs the spirit, Shen is said to emerge from the heart.

“The lungs are like ministers who assist the sovereign; they oversee the body’s regulation and restraint. Their position is exalted, but they are not the sovereign, so they are called the ‘office of the minister-assistant.’ They govern the circulation of nutritive Qi and defensive Qi, and are therefore responsible for regulating the body.

“The liver is like a general, from whom plans and deliberation arise. It has a courageous and decisive nature, so it is called the ‘office of the general.’ It can devise plans before matters become apparent, and so strategy and deliberation are said to arise from the liver.

“The gallbladder is like an impartial official, responsible for making decisions. It is upright and resolute, so it is called the ‘office of impartiality.’ It can decide directly without hesitation, and so decision-making is said to arise from the gallbladder.

“The chest center, located between the breasts and also called the Sea of Qi, is like a messenger who conveys the sovereign’s commands; joy and happiness arise from it. The heart governs the whole body like a sovereign who sends commands through the vessels. The chest center governs Qi and uses it to distribute Yin-Yang. When Qi circulates in harmony and the mind is at ease, joy arises. For this reason, the chest center is called the ‘office of the messenger.’

“The spleen and stomach are like storehouses for grain, from which the Five Flavors—the tastes and nutrients in food—are formed. The spleen and stomach receive the five grains like a storehouse, then transport the food’s essence throughout the body. Thus the Five Flavors are said to arise from them.

“The large intestine is like a pathway for conveyance, responsible for transmission and transformation. It sends undigested remnants downward and changes the form of food waste. For this reason, it is called the ‘office of transmission and transformation.’

“The small intestine is like an office that receives and holds substances, and is responsible for digesting food.”

Taking up the stomach’s function, it receives and holds food residue. After food enters, it transforms it and then passes it on to the large intestine. Thus the stomach is the official in charge of receiving and holding: it enables food to be transformed and discharged.

The kidneys are the officials in charge of strength and movement, able to bring about subtle effects.

Because the kidneys act with strength, they are called “making strong”; because they transform and generate the body, they are called “relying on skill.” In women, the function of “relying on skill” is chiefly expressed; in men, the function of “making strong” is chiefly expressed.

The Triple Burner is the official in charge of opening and regulating the flow of fluids; the waterways pass through it.

The Triple Burner guides the Qi of Yin and Yang and clears blockages, so it is in charge of keeping the waterways open.

The urinary bladder is the official in charge of gathering fluids. Body fluids are stored here, and they can be discharged only when the transformation of Qi functions properly.

The bladder is located in the lower part of the body and is like an independent bowel, so it is called the “official of the regional capital.” It is hollow inside and can therefore store body fluids. When the Qi of the Qi Sea—the part of the body associated with the circulation of Qi—drives the transformation of Qi, urine can be discharged. If the driving force of Qi is insufficient, urine remains trapped and cannot flow out. Thus, fluids can be discharged only when the transformation of Qi functions properly. The Ling Shu Jing says, “The kidneys connect upward to the lungs, and so can govern these two organs; the bladder, meanwhile, is an independent bowel.” This is what the passage means. “Jiu” is read as “jiu” and refers to urination.

These twelve officials cannot function without coordination among them.

If they fall out of balance, calamities will follow, so they must not lose harmony with one another. The New Collation explains: on close examination, only eleven officials are actually listed here, because the spleen and stomach together count as one official.

When the ruler is wise, the ministers remain at peace. If one cultivates life according to this principle, one can live long and avoid danger throughout one’s life. Applied to governing the realm, it can also bring prosperity to the state.

Here, “ruler” means both the sovereign and the heart, which rules the body. When the sovereign is worthy, rewards and punishments are applied consistently; when they are consistent, officials act according to the law; and when officials act according to the law, the people are not convicted through injustice or excessive punishment. Thus, when the ruler is wise, the realm is at peace. When the heart is clear, it can distinguish good from evil; when it can distinguish good from evil, it can recognize safety and danger; and when it can recognize safety and danger, the body will not be harmed by straying from the right path. Therefore, cultivating life according to this principle can bring longevity and keep one from falling into danger. Applied to personal cultivation, it protects people from danger; applied to governance, it can bring peace to the realm. When the sovereign governs by this principle, the state will prosper.

If the ruler of the heart is unclear, the body’s twelve offices will fall into danger. The channels through which Shen and Qi move will also become blocked, causing serious harm to the body. To care for one’s health in this condition will only invite disaster; to govern the world in this condition will leave its foundations gravely imperiled. One must be cautious—extremely cautious!

Here, “pathways” refers to the channels through which Shen and Qi move. When the ruler of the heart is unclear, it confuses the deviant with the proper. Unable to distinguish between them, one cannot judge what is beneficial and what is harmful, and so calamity follows; the body, too, becomes thin and weakened. This is why the body suffers serious harm, and why caring for one’s health in this way invites disaster.

The same applies to governing the world. When the ruler is unclear, he entrusts state affairs to his attendants and close ministers. If they seize power and act recklessly, officials cannot carry out the laws, and the people lose their place of security and suffer injustice. The people are the foundation of the state: only when the foundation is secure can the state be at peace. If the people cannot live in stability, how can the state endure? The ancestral temples, too, may be overturned and brought to ruin. Thus the words “one must be cautious—extremely cautious” mean that one must remain deeply alert. The character ji is read as jie and means “thin” or “weak.”

The highest and most wondrous Dao is subtle and profound, with transformations without end. Who can know its origin?

Shu means “who.” This sentence describes the workings of the utmost Dao: seen on a small scale, it is subtle and fine, reaching everywhere; seen on a large scale, it is vast and far-reaching, with transformations without end. Yet where, in the end, does it originate—and who can perceive that?

On the phrase “Jiong hu zai, xiao zhe qu qu,” the textual editors note that the Taisu reads “xiao zhe zhuo zhuo” instead; qu is read as qu.

Who can know its crucial point? Amid circumstances that are tangled and hard to understand, who can judge what is appropriate and what is good?

Jiong, “the crucial point,” is the key term; huoqu describes a rapid, swaying motion. The key to the workings of human life lies in the Dao (the fundamental principle governing the movement of all things). Yet even through observing changes in things and investigating their underlying principles, one may not truly grasp the subtle source of change, however diligently one seeks and strives for understanding. Since the principle is so difficult to know completely, it seems all the more profound and remote. Who, then, can truly grasp its essential subtlety?

Profound and remote principles cannot be fully attained through reasoning alone. Turn instead to what is close at hand and observe the self: the twelve officials—that is, the twelve major organs and functional systems of the body—can be investigated in broad outline, allowing one to understand how to care for the body. Minmin means “profound and remote,” while liang means “good” or “skilled.” The New Commentary notes that these lines are close in wording and meaning to a passage in the Treatise on the Five Movements and Six Qi; there the text reads xiao, “diminish,” while here it reads xiao, “vanish.”

The number in the indistinct and elusive arises from the tiniest fraction:

“Huanghu” describes something that seems both present and absent; hu is also a unit of extremely small measure. From what seems both present and absent, a number as minute as a hair’s breadth arises. The Laozi says, “Indistinct and elusive, yet within it there is something.” This is the state being described. The Book of Calculation also says that a state seeming both present and absent is called hu.

The number of tiny fractions begins with measures and standards. Multiply them by thousands and tens of thousands, and they can grow ever greater. Extend what is small into what is large, and its form can then be established:

Though tiny fractions are minute, when accumulated continuously and counted, they can give rise to measures, capacity units, straightedges, and standards. As they continue to increase, they can expand to immense quantities; by extending the small into the large, they can correspond to the form and structure of the human body.

The Yellow Emperor said, “Well said! I have heard that the Way of subtle illumination is the achievement of great sages. To proclaim and elucidate the Great Dao, I dare not receive this teaching without first performing a purification and selecting an auspicious day.”

This was because the Yellow Emperor felt profound reverence. Han Kangbo said, “Cleansing the mind is called zhai; preventing stray thoughts from intruding is called jie.”

The Yellow Emperor therefore selected an auspicious day and favorable omen, and stored these teachings in the Chamber of the Numinous Orchid, where the Yellow Emperor’s palace kept its treasured texts, so that they could be transmitted and preserved. In this way, the scriptures were guarded with the utmost solemnity.

The Yellow Emperor asked, “I have heard that Heaven forms the year according to the rhythm of ‘six times six,’ while the human body is organized according to the rule of ‘nine times nine.’ On close examination, the human body also has 365 joints, corresponding to Heaven and Earth. This account has been handed down for a long time, but I do not understand its reasoning.”

The “rhythm of six times six” refers to dividing the periods of the year according to the cycle of the sixty combinations of the Ten Heavenly Stems and Twelve Earthly Branches. “Ninefold calculation and correspondence” uses the number nine to derive the count of the Nine Regions of Heaven and Earth, explaining how the different parts of the human body come together and relate to one another. The scripture holds that the body’s 365 joints correspond to the seasons and times of Heaven. But if “nine times nine” is also treated as a cycle for reckoning years, a full cycle would take more than two years, making the principle difficult to explain. The textual editors point out that the reading should be “two years and one quarter of a year make one cycle.”

Qibo replied, “That is a very clear question. Allow me to explain it in detail. The so-called ‘rhythm of six times six’ and ‘ninefold calculation and correspondence’ are used to calibrate the degrees of celestial movement and the sequence of seasonal changes.”

The “six sixes” form a cycle in the division of the year into solar terms, while the “nine nines” are numbers used to align and calculate changes in the transformation of Qi. The “numerical measure of Qi” mentioned here refers to the Qi on which the generation of all things depends. The celestial bodies complete one circuit in about 365¼ degrees. Dividing the year evenly into twelve solar-term sections and calculating it as 360 days still leaves a discrepancy. Since months also differ in length, these differences must be accumulated and intercalary months inserted to make adjustments.

The generation and nourishment of all things by Heaven and Earth fundamentally depend on Yin-Yang; human activity and the workings of the world are, in turn, always governed by the nine Qi. The number nine plays a major role in calculating the transformation of Qi. The Book of Pitch Pipes says that the Yellow Bell pitch pipe is nine inches long, and that when the solar term arrives at the winter solstice, the ash inside the pipe flies up. This shows that the ancients used pitch pipes to sense the solar terms and believed the generation of all things to be connected with the nine Qi. The ancient measure of nine inches is equivalent to about seven inches and three-tenths by today’s standards. Because standards of measurement have changed over time, the dimensions also differ. A later editor noted that some editions write “two-tenths” where others have “three-tenths.”

“Celestial degrees” are a measure used to determine the movements of the sun and moon; the “numerical measure of Qi” is the framework used to record the growth and action of Qi’s transformations. Measuring the movements of the sun and moon reveals that they move at varying speeds. Recording the framework of Qi’s transformations explains how all things change in response when a solar term arrives. When the solar terms are accurately sensed, the patterns governing the generation of all things remain orderly; when the movements of the sun and moon are calculated in degrees, the lengths of the months can be determined. In this way, changes in the duration of daylight, the alternation of cold and heat as the months pass, and the storing away and growth of all things can all follow the seasons.

Heaven belongs to Yang and Earth to Yin; the sun belongs to Yang and the moon to Yin. The sun and moon each follow their own patterns of motion, repeating in cycles. The sun travels about one degree each day, while the moon travels a little more than thirteen degrees. Thus, the movements of the sun and moon, together with the accumulated solar terms, make up a year of roughly 365 days. As the accumulated excess Qi gradually increases, intercalary months are used to bring the calendar into balance.

The Sun moves relatively slowly, covering only one degree of the celestial sphere each day. It takes 365 days to complete one circuit, with a small fraction of a day left over. The Moon moves faster, covering more than thirteen degrees each day and completing a circuit in about twenty-nine days. The word “more” means that, beyond thirteen degrees, the Moon travels an additional seven parts of one nineteenth of a degree. That is why it is said to move more than thirteen degrees each day.

The Book of Rites and the Treatise on Calendars and Astronomy from the Han dynasty record that the Twenty-Eight Lunar Mansions—the divisions of the sky made by the ancients—and the other stars all set out from the east and move westward across the sky. The Sun, Moon, and Five Planets—Jupiter, Mars, Saturn, Venus, and Mercury—set out from the west and move eastward across the sky. Today, however, the Grand Astrologer, the official in charge of astronomy and calendrical matters, says that they all move eastward across the sky: that is, they set out from the east and turn westward.

Calendar specialists hold that the Moon moves fastest from the first through the fourth day of the month, traveling more than fourteen degrees per day. From the fifth through the eighth day it slows somewhat, traveling more than thirteen degrees per day. From the ninth through the nineteenth it is slowest, traveling more than twelve degrees per day. From the twentieth through the twenty-third it speeds up somewhat, traveling more than thirteen degrees per day. From the twenty-fourth through the end of the month it moves quickly again, traveling more than fourteen degrees per day. The Moon’s speed, as described by the Grand Astrologer today, does not follow this pattern. He holds that sometimes it moves faster in the first half of the month and slower in the second, and sometimes the reverse. In general, the month can be divided into four periods, each with its own changes in speed; the Moon’s motion has no fixed rate.

Even so, the Moon takes about twenty-seven days to complete one circuit of the celestial sphere, covering 361 degrees. By the twenty-ninth day, the Sun has traveled twenty-nine degrees, while the Moon has traveled 387 degrees—seven degrees farther than the Sun. On the thirtieth day, the Sun continues its course, and, by calculation, has traveled eight thirteenths of a day’s motion when the Moon catches up with it. This is a long month. Broadly speaking, if calculation puts the Moon’s return to the Sun at half a day’s motion out of thirteen, the month is also counted as long. If the Moon catches up after five thirteenths and five sixths of a day’s motion, the month is counted as short. Long and short months together make up 365 days and form a year.

Strictly speaking, a year should be 365 and one-quarter days. Since this extra portion is less than a whole day, only whole days are counted here. If six short months are counted together, the year has only 354 days, more than eleven days short of the actual length. The days missing from the months are therefore added to the remaining days of the year. Once the accumulated total reaches about thirty-two days, an excess appears, forming an intercalary month. The Book of Documents says: “A year has 366 days; intercalary months are used to adjust the four seasons and establish the divisions of the year.” This is the principle it describes. In calendrical calculations, accumulated fractions eventually produce an intercalary month because the calculation is based on the lengths of the months and does not fully account for the minute differences in the celestial bodies’ movements.

In setting the calendar, establish the starting point of the solar term at the beginning of the month, mark at midmonth the direction indicated by the Dipper’s handle, and assign the surplus days to the end of the year to create leap months. Only then is the calculation of the heavenly bodies’ cycles complete.

Here, “endpoint” means the starting point, and “beginning” refers to the start of the month. “Mark” means to indicate, while “alignment” refers to the Dipper’s position—that is, determining direction from where the Big Dipper’s handle points. “Midpoint” means the middle of the month, and “defer the surplus” means to set aside extra days for later. Usually, before a leap month, the progress of the solar terms falls behind the months; after a leap month, the months in turn fall behind the solar terms. Ordinary months therefore have markers at the beginning and middle, while leap months have no fixed markers for either. Even when a calendar lists dates for a leap month, these are simply the days on which other solar terms occur. This shows that when arranging the calendar, one must set the starting point at the beginning of the month, mark the direction at midmonth, and defer the surplus to the end of the year. By calculating the days and inserting leap months in this way, the calendar can account fully for the seasons and celestial cycles.

The Yellow Emperor said, “I understand the calculations of the celestial cycles now. How do the numbers of Qi fit with them?” Qibo replied, “Heaven uses six times six to mark its divisions; Earth uses nine times nine to establish their correspondences.” A textual critic notes that at the beginning of the chapter there is also the statement, “Humanity uses nine times nine to establish their correspondences.”

Heaven has ten stem days: Jia, Yi, Bing, Ding, Wu, Ji, Geng, Xin, Ren, and Gui. Sixty days make one cycle, called a “Jia cycle.” Repeating this cycle six times gives a calendrical year of 360 days. These 360 days are the number of days in a calendrical year, not the actual measure of the celestial bodies’ movements. This calculation takes a year as twelve months of thirty days each; when shorter months are included, the total number of days differs.

Since ancient times, all who understood the Dao of Heaven have known that the root of life lies in Yin-Yang. Human Qi, the Nine Regions, and the nine orifices all communicate with the Qi of Heaven.

“Connecting with Heaven” refers to primal Qi—the true vital energy. The human body takes shape through the earth, but life is bestowed by Heaven. The Qi that sustains life therefore connects with Heaven, receives Yin-Yang Qi, and becomes the foundation of life. The Treatise on the Preciousness of Life and the Integrity of Form says, “People are born from the earth, while their lives rest on Heaven. Only when the Qi of Heaven and Earth come together does human life arise.” The Comprehensive Treatise on Regulating the Spirit in Accord with the Four Qi says that Yin-Yang and the four seasons govern all things from beginning to end and are the basis of life and death. It also says that going against this basis harms the roots of life and damages its true Qi. This is precisely what is meant here.

“The Nine Provinces” refers to Ji, Yan, Qing, Xu, Yang, Jing, Yu, Liang, and Yong. The land is divided into nine provinces, and the human body has nine openings: two eyes, two ears, two nostrils, the mouth, and the two lower openings. Since the movement of the human spirit and the flow of breath correspond to Heaven and Earth, the “Nine Provinces” are said to correspond to the “nine openings.” The Lingshu Jing says, “The earth has nine provinces; people have nine openings.” This is the principle it describes.

The passage begins by speaking of “Qi” to indicate that the true Qi of Heaven is always present within the human body. The connection between Heaven and humanity is never severed, and the true spirit—the essential reality and spiritual nature of human life—resides within. Thus, whether one is active or still, outwardly manifest or inwardly contained, one remains connected with Heaven. This is what “all are connected with the Qi of Heaven” means.

Thus, the human body is formed by the Five Phases, while the Qi of life has three kinds.

The body’s continued existence depends on the workings of the Five Phases; tracing life back to its source, it is formed by three kinds of Qi. Hence it is said that the body is formed by the Five Phases and the Qi of life has three kinds. These three kinds of Qi also correspond to the “Three Origins,” the three foundations of Heaven, Earth, and humanity in Daoist teaching. The following passage explains this point.

The New Corrected Text says: From “Since ancient times, those who connected with Heaven” to this point, the text matches the Treatise on Qi Connecting with Life, though the commentary differs slightly. The two passages should be read together for comparison.

Heaven, Earth, and humanity are each formed by three kinds of Qi.

Humanity is not alone in being formed through the three kinds of Qi; the workings of Heaven and Earth follow this same principle. The hexagrams of the Qian and Kun trigrams and the other hexagrams in the Book of Changes are each made up of three lines.

Each of the three divides into three, together making nine. The nine then divide into the Nine Fields, the nine regions, which correspond to the body’s nine organs—the system of viscera associated with the Nine Provinces and the nine openings.

The “Nine Fields” correspond to the nine zang organs, and this is how they got their name. The Erya records that the area beyond the city walls is called the “suburbs,” the land beyond the suburbs the “outer district,” beyond that the “pasture,” then the “forest,” then the “open country,” and finally the “wilderness.” These are the successive zones being described. The Newly Revised Commentary points out that the wording in the current Erya differs from the passage Wang Bing quotes: it says that the land beyond the suburbs is called the “pasture,” beyond the pasture the “wilderness,” beyond the wilderness the “forest,” and beyond the forest the “open country.”

There are four bodily zang and five spirit zang, making nine in all, corresponding to the Nine Fields.

The four bodily zang are the head, the ears and eyes, the mouth and teeth, and the chest. Because they are apparent on the outside of the body, they are called “bodily zang.” The five spirit zang are the liver, heart, spleen, lungs, and kidneys. Because they are housed within the body, they are called “spirit zang.” The term “spirit zang” refers to the liver housing the hun, the heart housing the spirit, the spleen housing intention, the lungs housing the po, and the kidneys housing will. The bodily zang and spirit zang are these two distinct groups. The Newly Revised Commentary explains that this account also appears in the annotations to “The Treatise on the Five Kinds of Qi Manifested in the Brightness” and “The Treatise on the Three Regions and Nine Indicators.” For a detailed explanation of the names “bodily zang” and “spirit zang,” see the annotation to “The Treatise on the Three Regions and Nine Indicators.”

The Yellow Emperor said, “I have already heard about the principles of the six cycles of six and the meeting of nine cycles of nine. You have also spoken of the accumulation and intercalation of Qi. What is Qi? I ask you, Master, to dispel my ignorance and resolve my doubts.”

With these words, he was asking the Master to expound the essential principles and speak of what he had not yet heard, resolving his doubts so that even the unenlightened might understand.

Qibo replied, “This is a principle kept secret by the Supreme Lord and passed down to me by my former teacher.”

“The Lord on High” refers to the imperial sovereign of ancient times. The “former master” was Yi Daiji, the teacher of the ancestral master Qibo. In ancient times, he excelled at reading a person’s complexion and examining the pulse. The Treatise on the Transfer of Essence and the Transformation of Qi says: “In ancient times, the Lord on High had Yi Daiji examine people’s complexions and pulses in order to understand the principles of the spirits.” The preface to the Scripture of the Eight Essentials says: “The Celestial Master answered the Yellow Emperor: I studied the examination of complexions and pulses under Yi Daiji, and three generations have passed since then; one may say that I understand all these principles.” The editorial reviser says: “On close examination, ‘essentials’ is written once as ‘search’; some also think ‘eight’ should be ‘great.’” However, this passage does not appear in the surviving Great Plainness. The pronunciation of “Yi” is close to that of “jiu.”

The Yellow Emperor said: “Please continue.”

“Sui” means complete, or thorough.

Qibo said: “Five days are called a ‘hou’; three hou make one ‘qi’; six qi make one ‘season’; and four seasons make one year. Each stage is governed and regulated by its corresponding qi.”

The sun travels about five degrees each day, so five days make one hou; three hou amount to exactly fifteen days. Six qi total ninety days, exactly three months. The commentator holds that the periods of the six qi can be reckoned as eighteen hou; the six qi together make one season. The four seasons total about three hundred and sixty days, and thus make up one year. “Each follows its own governing influence” means that every day of the year belongs to one of the qi of the Five Phases, which governs and acts upon it. The text therefore continues:

“The Five Circulations succeed one another in order, each governing its season. When a cycle reaches its end, it begins again. The seasons are established, the qi are distributed, and the cycle turns without end, like a ring; the pattern of the hou’s movement is the same. Therefore, anyone who does not understand which qi is in motion each year, how its strength waxes and wanes, and how deficiency and excess arise cannot be considered a competent physician.”

Here, “hou, qi, season, and year” are the ancient divisions of seasonal time. The “Five Circulations” refers to the changes in the qi of the Five Phases as they move through the year.

The “Five Movements” are the Qi of the Five Phases—Wood, Fire, Earth, Metal, and Water. They move in accordance with the seasons and govern the transformations of all things. “Following in succession” means taking up what came before, like a legitimate son inheriting his father’s work. The Qi of the Five Phases succeed one another, each governing for a period of time, then repeating the cycle without end.

“Season” here means the seasonal period that should arrive around the Beginning of Spring; “Qi” means the pulse Qi governed by that season. Before spring arrives, spring Qi comes first, and the corresponding pulse Qi appears with it. This is what is meant by “the season is established and its Qi is distributed.” “Phase” refers to the period corresponding to the sun’s passage through a particular position. Within each phase, the Five Qi also generate one another in sequence. If the pulse Qi fails to correspond to the season, illness may result.

The Treatise on Moving Essence and Changing Qi says that in ancient times physicians assessed the complexion and examined the pulse, understood the principles of spiritual clarity, and related the human body to Metal, Wood, Water, Fire, and Earth; the four seasons; the eight winds; and the six directions. Their examinations thus followed established methods. This is the principle being described here. “Skilled practitioner” means someone adept at caring for and treating the body. Only by understanding these principles can one deal calmly with the illnesses of the world.

The New Corrected Edition adds: According to Wang Bing’s commentary, “the season is established and its Qi is distributed” means that around the Beginning of Spring, the season arrives and the pulse Qi governing that season appears with it. A closer reading shows that the passage describes the establishment of the four seasons throughout the year and the timely circulation of the Six Qi, repeating without end. The changes in each phase follow the same pattern.

The Yellow Emperor asked: “The Five Movements begin their cycle and repeat without end. What happens when the Qi of the Five Phases is excessive or insufficient?”

Qibo replied: “The Five Qi take charge in turn, and each has something that restrains it. Changes between abundance and deficiency are normal features of this movement.”

In other words, the Five Qi are sometimes in excess and sometimes deficient; this is a natural principle of their movement.

The Yellow Emperor asked: “What is it when the Qi is balanced?”

Qibo replied: “It means there is no deviation.”

When neither the climate nor the seasons depart from their usual course, the Qi is said to be balanced.

The Yellow Emperor asked again: “What about excess and insufficiency?”

Qibo replied: “The classics have already explained this.”

Wang Bing considered the Treatise on the True Viscera of the Jade Pivot to have discussed in detail the balance, excess, and insufficiency of the Five Qi. The New Corrected Edition points out, however, that the Treatise on the True Viscera of the Jade Pivot addresses excess and insufficiency in the pulse, not excess, insufficiency, and balance in the Qi of the Five Movements. Those topics are discussed in the Treatise on Changes in the Qi Between Heaven and Earth and the Treatise on the Five Constant Governments.

The Yellow Emperor asked, “What is meant by ‘that which overcomes’?” Qibo replied, “Spring overcomes late summer; late summer overcomes winter; winter overcomes summer; summer overcomes autumn; and autumn overcomes spring. This is how the Qi of the Five Phases (Wood, Fire, Earth, Metal, Water) overcomes one another in their respective seasons, with the corresponding seasonal Qi used to name the associated organs.

“Spring belongs to Wood, and Wood can overcome Earth. Late summer belongs to Earth, and Earth can overcome Water. Winter belongs to Water, and Water can overcome Fire. Summer belongs to Fire, and Fire can overcome Metal. Autumn belongs to Metal, and Metal can overcome Wood. This is the usual sequence. Late summer is added to the four seasons, so the Qi of the Five Phases overcomes one another according to the seasons. Here, ‘late summer’ refers to the sixth lunar month. Earth is generated by Fire and gradually grows strong during summer. By this time, it has matured and become vigorous, which is why it is called late summer. To name the organs according to seasonal Qi means that spring’s Wood corresponds to the liver, late summer’s Earth to the spleen, winter’s Water to the kidneys, summer’s Fire to the heart, and autumn’s Metal to the lungs. ‘To name’ means to give a name.”

The Yellow Emperor asked, “How can we know which season’s Qi has gained the upper hand?” Qibo replied, “We must observe when the seasonal Qi arrives. These seasonal Qi are all calculated from the beginning of spring.”

The commentary explains that the beginning of spring is the day on which spring starts. Since spring begins the four seasons of the year, observations of seasonal Qi are based on the days around the beginning of spring.

“When seasonal Qi arrives before its proper time, this is called excess. Qi in excess presses upon the Phase it cannot overcome and takes advantage of its strength to overcome the Phase it can overcome. This is called ‘Qi overflows.’”

The commentary points out that the ten characters from “arrives before its time” through “the practitioner cannot restrain it” do not connect smoothly with the surrounding text and may have been misplaced in the ancient text. Their meaning should belong after the later passage on the “five regulations”; the commentary marks them there in red.

“When seasonal Qi fails to arrive at its proper time, this is called insufficiency. Qi that is insufficient allows the Phase it can overcome to escape restraint and act recklessly. The Phase it generates falls ill, while the Phase that can overcome it comes to press upon it. This is called ‘Qi presses.’ To determine when seasonal Qi arrives is to observe the season in which it actually appears.”

The time when the Qi of the Five Phases arrives is reckoned from fifteen days before the Start of Spring, which marks the beginning of the first climate phase. When Qi should arrive later but arrives early, this is called “arriving before its time”: the Qi responsible for that period arrives before its appointed time. Early arrival indicates excess strength, and is therefore called “excess.”

When Qi does not arrive at its appointed time and comes only later, this is called “failing to arrive when due.” It indicates that the Qi of that period is weak, and is therefore called “deficiency.”

When Qi is in excess, it presses upon the Phase that cannot overcome it and takes advantage of its strength to invade the Phase it can overcome. When Qi is deficient, the Phase it would normally overcome is no longer restrained and acts unchecked. The Phase it generates also becomes afflicted, while the Phase that overcomes it comes to press upon it. In the relationships among the Five Phases, the Phase I overcome is called “that which I overcome”; the Phase that overcomes me is called “that which cannot be overcome”; and the Phase that generates me is called “that which generates me.”

For example, the Liver belongs to Wood. If Liver-Wood is in excess, Lung-Metal can no longer restrain it, and Wood Qi becomes excessive. When Wood Qi grows too strong, it in turn presses upon Lung-Metal and takes advantage of its strength to invade Spleen-Earth. This is what is meant by “in excess, it presses upon that which cannot overcome it and takes advantage of that which it can overcome.” When the Qi of the Five Zang organs invades and combines with one another inside the body, causing illness, this is called “Qi running rampant.” The same applies to excess in the other Phases.

For another example, if Liver-Wood Qi is deficient, it cannot restrain Spleen-Earth. Earth Qi then acts unchecked, and Wood is bullied by Earth. This is what is meant by “that which it overcomes acts unchecked, while that which generates it becomes afflicted.” When Liver-Wood loses its balance, Lung-Metal Qi also comes to press upon it; hence the phrase “that which cannot be overcome presses upon it.” With Wood Qi out of balance, Earth and Metal Qi press upon it in turn, harming one another and causing illness. This is called “Qi pressing upon it.” The same applies to deficiency in the other Phases.

Only by carefully observing the time when Qi arrives can one foresee its changes. If one misses the proper time and goes against the patterns of the seasons, the Five Phases’ governing functions will fall into disorder, pathogenic Qi will arise within the body, and the physician will be unable to prevent it.

Here, “time” means the time when Qi arrives. To observe the Qi of the year, one begins from the Start of Spring; to observe the Qi of each period, one follows the fixed sequence of the four Qi; to observe a particular day, one follows the dates of each climate phase. This is why one must carefully observe the seasons in order to foresee changes in Qi. “Go against” means to violate. The “five governing functions” are the roles by which each of the Five Phases presides over and governs the climate throughout the year. If one cannot distinguish what each Phase governs, one may mistakenly bring pathogenic Qi into the body. If one has not fully grasped the true patterns of Heaven and Earth’s movement, how could one precisely understand the roots of illness? That is why it is said that the physician will be unable to prevent it.

The Yellow Emperor asked, “Are there cases that do not follow this pattern?”

The Qi of the heavens does not move without a pattern. When its movement fails to follow the usual sequence, it is called “irregular”; when an anomaly appears, change follows.

Here, “change” means that the weather shifts away from its normal pattern.

The Yellow Emperor asked, “What happens when an irregular change occurs?” Qibo replied, “Once change arrives, it can make people ill. If the Five Phase that is overcome by the pathogenic Qi happens to be weak, the illness will be mild; if the Five Phase that it cannot overcome is strong, the illness will be severe. If the person is then repeatedly exposed to pathogenic Qi, they will die. Thus, when pathogenic Qi is out of season, illness is mild; when it is in season, illness is severe.”

Even the heavens, in dispensing the seasons, do not depart from the patterns of the Five Phases. Should people, who live amid the Qi of Heaven and Earth, not follow the Dao of Heaven? When the movement of a person’s Qi becomes disordered and fails to accord with the seasons, signs of illness and even death will appear. The Zuo Tradition says, “To defy the Dao of Heaven is inauspicious.” This is the kind of situation it describes.

For example, in a year when Wood Qi is in season, an invasion by Fire Qi may cause illness the following year; an invasion by Earth Qi may cause illness in the third year; an invasion by Metal Qi may cause illness in the fourth year; and an invasion by Water Qi may cause illness in the fifth year. If a person’s righteous Qi is already weak and they are exposed to pathogenic Qi again, their righteous Qi will weaken further, and they may die.

If it is not a year when a particular Phase is in season, but another Qi comes to invade, the result is usually only a mild illness. It will not damage the inner spirit-storing organs, so the illness remains mild and is more likely to persist. In a year when the corresponding Phase is in season, people are more susceptible to pathogenic Qi, and the illness is therefore more severe. Each kind of Qi can readily make people vulnerable to illness when it is in season. Hence the saying: illness is mild when it is out of season, and severe when it is in season. The Treatise on the Comprehensive Discussion of Deficiency and Excess says, “When it is not their time, they live; when it is their time, they die.” Here, “their time” means the year when a particular Phase is in season.

The Yellow Emperor said, “Good. I have heard that when Qi combines, it forms tangible things, and that their names are determined by their transformations. When Heaven and Earth move, and Yin-Yang acts upon the myriad things, how abundant are the different kinds of things? Can you explain this to me?”

The New Collation says: The passage from “Qibo said, ‘What a clear question!’” in the preceding text to this point does not appear in either Quan Yuanqi’s annotated edition or the Taizu. It is suspected that Wang Bing added it.

Qibo said, “What a comprehensive question! Heaven is so vast that it cannot be measured; Earth is so immense that it cannot be gauged. You have raised such a profound question. Allow me to set out its essential points.”

Heaven and Earth are vast and boundless, beyond measurement. The transformations through which nature generates and changes things are also profound and subtle. How could the human mind understand them all? The Yellow Emperor, endowed with the keen insight of a great spirit, sought guidance from Qibo. Qibo praised the emperor’s wisdom, then offered only the broad essentials and a rough outline of the principles. Thus he said, “Allow me to set out the method.”

Plants grow in countless colors, and their changing hues cannot all be seen; they grow with flavors of every kind, and their delicious tastes cannot all be sampled. The myriad things are numerous, and each receives nature’s transformations in its own way. People cannot fully know even everything they see with their eyes and taste with their tongues. How, then, could the human mind encompass it all?

People differ in their likes and desires, each favoring and responding to different things. Though colors and flavors are too numerous to exhaust one by one, people tend to choose what they like and seek in ways that accord with their own inclinations.

Heaven nourishes people with the Five Qi, and Earth nourishes them with the Five Flavors. The Five Qi provided by Heaven are the agitating Qi that enters the liver, the scorching Qi that enters the heart, the fragrant Qi that enters the spleen, the fishy Qi that enters the lungs, and the putrid Qi that enters the kidneys. The Five Flavors provided by Earth are sour, which enters the liver; bitter, which enters the heart; sweet, which enters the spleen; pungent, which enters the lungs; and salty, which enters the kidneys. Clear Yang Qi transforms into Qi, rises, and becomes Heaven; turbid Yin condenses into flavor, descends, and becomes Earth. Thus it is said that Heaven nourishes people with Qi and Earth nourishes them with flavor. The “Treatise on the Correspondence of Yin and Yang” also says, “Clear Yang is Heaven; turbid Yin is Earth,” and “Yang is Qi; Yin is flavor.”

The Five Qi enter through the nose and are stored in the heart and lungs, bringing a healthy glow to the complexion and clarity and strength to the voice. The Five Flavors enter through the mouth and are stored in the intestines and stomach. The essence of the food stored there then nourishes the Five Qi. When the Five Qi are harmonized, life can grow, and body fluids—the fluids within the human body—are produced. Body fluids and Qi work together to generate Shen Qi, sustaining and enabling the activities of life.

The Yellow Emperor asked, “What are the outward manifestations of the zang-fu organs?”

“Manifestations” means what can be observed from the outside.

Qibo said: The heart is the root of life’s activity and the place where the spirit (Shen) functions. Its flourishing is reflected in the complexion, and it nourishes the blood vessels. The heart belongs to the greatest Yang within Yin-Yang and corresponds to the qi of summer.

The heart is like the office of a ruler, from which the spirit emerges. A ruler determines whether all things flourish, decline, survive, or perish. That is why the heart is called the root of life and the place where the spirit functions. Fire qi rises, so the heart’s flourishing is reflected in the complexion. The heart nourishes the blood and governs the blood vessels; this is why its nourishing action is said to be expressed in the vessels. The heart is most vigorous in summer, and its qi corresponds to the sun. The sun’s qi is present amid summer’s fire qi, so the heart is called “the greatest Yang within Yin” and is said to correspond to summer qi. The “Treatise on the True Words of the Golden Coffer” says that from dawn until noon is the period when the Yang qi of Heaven circulates, and is Yang within Yang. The New Collation notes that the version by Quan Yuanqi and the Taisu have “the dwelling place of the spirit” where this text reads “the transformations of the spirit.”

The lungs are the root of qi and the dwelling place of the Po, the spirit aspect associated with bodily activity. Their flourishing is reflected in the fine body hair, and they nourish the skin. They are the greatest Yin within Yang and correspond to the qi of autumn.

The lungs store qi; their spirit aspect is the Po, and they nourish and protect the skin and body hair. Thus the lungs are called the root of qi and the dwelling place of the Po, their flourishing appears in the body hair, and their nourishment is expressed in the skin. The lungs belong to the qi of Greater Yin and are most vigorous in autumn. Daytime is governed by Yang qi; although the lungs belong to Greater Yin, they are situated within the period when Yang qi circulates. They are therefore called “the greatest Yin within Yang” and are said to correspond to autumn qi. The “Treatise on the True Words of the Golden Coffer” says that from noon until dusk is the period when the Yang qi of Heaven circulates, and is Yin within Yang. The New Collation argues that the Jia Yi Jing and the Taisu both read “Lesser Yin” where this text has “Greater Yin,” and that it should be changed to “Lesser Yin.” Although the lungs belong to the Greater Yin channel among the twelve channels, this passage describes them as being within the period when Yang qi circulates; according to their position within Yin-Yang, they should therefore be called “Lesser Yin.”

The kidneys govern fluids and have the function of sealing and storing; they are the dwelling place of Jing and qi. Their flourishing is reflected in the hair, and they nourish the bones. They are the lesser Yin within Yin and correspond to the qi of winter.

The earth’s portals close and conceal themselves in winter, and insects, too, retreat deep into hiding. The Kidneys govern Water. They receive the vital energy of the five zang organs and six fu organs and store it. Thus the Kidneys govern hibernation and concealment: they are the foundation of sealing and storing, and the place where vital energy is kept. The brain is where marrow gathers. The Kidneys govern the bones and marrow, and the hair is nourished by the brain’s marrow. Therefore, the Kidneys’ flourishing is seen in the hair, while their fullness is seen in the bones. The Kidneys store Jing and belong to Yin; they also correspond to winter, the season when Yin energy is at its strongest. Thus they are called Lesser Yin within Yin and are linked to the Qi of winter. The “Treatise on the True Words of the Golden Coffer” says: From nightfall until the crowing of the rooster is Yin time in Heaven, and within it is Yin within Yin.

The New Textual Revision, a note by the collator, points out that the versions by Quan Yuanqi, the Jia Yi Jing, and the Tai Su all write “Greater Yin” here instead of “Lesser Yin”; therefore, the text should read “Greater Yin.” Although the Kidneys belong to Lesser Yin among the twelve channels, when the levels within Yin are distinguished, they belong to Greater Yin.

The Liver is the foundation of the body’s endurance of exertion and fatigue, and the place where the Hun resides. The Liver’s flourishing is seen in the nails, while its fullness is seen in the sinews. It generates and transforms blood and Qi; its corresponding flavor among the Five Flavors is sour, and its color is blue-green.

The New Textual Revision points out that the six characters “its flavor is sour, its color blue-green” should be removed from the classic text. The Tai Su also records the flavors and colors corresponding to the Heart, Lungs, and Kidneys; moreover, the “Treatise on the Correspondences of Yin and Yang” already explains the colors and flavors of the five zang organs in detail, so there is no need to repeat them here. The collator holds that only the passages on the flavors and colors of the Liver and Spleen need to be removed; the forty-one characters quoted in the commentary from the “Treatise on the Correspondences of Yin and Yang” should also be deleted. The character “ba” is read as “pi,” meaning “fatigue.”

Among the Yang energies, the Liver belongs to Lesser Yang and is linked to the Qi of spring.

All bodily movement depends on the strength of the sinews. The Liver governs the sinews and stores the Hun, or ethereal soul. It is therefore called the foundation that enables people to endure exertion, and the dwelling place of the Hun. The nails are the tips of the sinews, which are nourished by Liver Qi. Thus the Liver’s flourishing appears in the nails, while its nourishment is expressed in the sinews.

The East is the direction in which all things begin to grow, and it governs the rising and generation of blood and Qi. The “Treatise on the Correspondence of Yin and Yang” says: “The East generates wind; wind generates Wood; Wood generates sourness.” The Liver corresponds to Wood, so its flavor is sour. The same treatise says that Shen is stored in the Liver and that its outward color is green; therefore, the Liver’s color is green. The Liver corresponds to the Qi of lesser Yang. It occupies a Yang position and flourishes in spring, so it is called “the lesser Yang within Yang” and is in correspondence with the Qi of spring.

The “Treatise on the True Words of the Golden Coffer” says: “From dawn until noon is the Yang Qi of Heaven, and within this period the Yang Qi is at its fullest.” The New Collation considers the readings in the Quan Yuanqi edition, the Jia Yi Jing, and the Tai Su—all of which give “the lesser Yang within Yin”—more appropriate. Wang Bing cites the period from dawn until noon as “Yang within Yang” to explain why the Liver is called “the lesser Yang within Yang,” but does not cite the period from midnight until dawn as “Yang within Yin.” In light of the explanation that the Heart is called “the greater Yang within Yang,” this passage should follow the editions mentioned above and read “the lesser Yang within Yin.”

The Spleen, Stomach, Large Intestine, Small Intestine, Triple Burner, and Bladder are the foundation for storing and transporting food and drink. They are also the places on which the movement of nutritive Qi—the Qi that nourishes the body—depends, and are therefore called “vessels.” They can digest food and drink, transform its flavors, and allow it to enter and leave. Since they can receive and hold the various kinds of food and drink while continually transporting them, they are called “the foundation of the granaries.” Nutritive Qi is generated in the middle burner, the region where the Spleen and Stomach are located, so this is said to be where nutritive Qi resides. The flavors of food and drink enter the Spleen and Stomach, are digested and transformed, and are then discharged through pathways such as the Triple Burner and Bladder. Thus they are said to transform flavors and enable them to enter and leave.

The flourishing of the Spleen and Stomach appears around the lips, while their nourishment is expressed in the muscles. Their flavor is sweet, and their color is yellow.

The textual editor states: “These six characters after ‘The newly revised text says’ should be deleted, as should the forty characters quoted from the Treatise on the Correspondences of Yin and Yang in the commentary; the relevant material has already been explained in the preceding entry.”

The Spleen belongs to the category of Utmost Yin and is linked with Earth Qi. The mouth is the Spleen’s external gateway, and the Spleen governs the muscles. Its flourishing is therefore reflected in the pale skin around the lips, while the muscles are the part nourished by it. Here, “the four whites” refers to the lighter-colored skin surrounding the lips. The Treatise on the Correspondences of Yin and Yang says: “The center generates dampness; dampness generates Earth; Earth generates sweetness.” The Spleen corresponds to Earth, so its flavor is sweet; among the Five Colors, it corresponds to yellow. The Spleen stores Earth Qi, and Earth is also associated with Utmost Yin. Thus, the Spleen is said to belong to Utmost Yin and to be linked with Earth Qi. The Treatise on the True Words of the Golden Cabinet says: “The Utmost Yin within Yin is the Spleen.”

“The eleven viscera depend on the Gallbladder” means that, counting from the Heart and the other organs through to the Gallbladder, there are eleven viscera in all. The Gallbladder is upright and decisive, without partiality; therefore, the order in which the eleven viscera function depends on the Gallbladder.

The following passage describes how to determine the location of an illness by comparing the strength of the Renying pulse (the artery in the neck) with that of the Cunkou pulse (the pulse at the wrist). If the Renying pulse is twice as strong as the Cunkou pulse, the illness is in the Shaoyang; if three times as strong, it is in the Taiyang; and if four times as strong, it is in the Yangming. If it is more than four times as strong, this is called “blocking Yang,” meaning that Yang Qi is excessive and obstructs food, making it impossible to eat. The Treatise on Correct Principles says that “blocking” causes vomiting. Here, Shaoyang, Taiyang, and Yangming correspond respectively to the channels of the Gallbladder, Bladder, and Stomach. The Spiritual Pivot Scripture describes similar pulse signs in the hand channels: when the Renying pulse is twice as strong and agitated, it corresponds to the Hand Shaoyang Sanjiao channel; when three times as strong, to the Hand Taiyang Small Intestine channel; and when four times as strong, to the Hand Yangming Large Intestine channel.

Conversely, if the Cunkou pulse is twice as strong as the Renying pulse, the illness is in the Jueyin; if three times as strong, it is in the Shaoyin; and if four times as strong, it is in the Taiyin. If it is more than four times as strong, this is called “blocking Yin.”

This describes the pulse conditions of the Yin channels. Jueyin corresponds to the Liver pulse, Shaoyin to the Kidney pulse, and Taiyin to the Spleen pulse. The Lingshu Jing records that when the Qi of the Hand Jueyin channel reaches twice its normal strength, the pulse becomes rapid and forceful. At three times its normal strength, the Hand Shaoyin pulse shows the same signs; at four times, the Hand Taiyin pulse does as well. Hand Jueyin is the Pericardium pulse, Hand Shaoyin the Heart pulse, and Hand Taiyin the Lung pulse. The method for assessing whether channel Qi is strong or weak is the same as for the Yang channels.

When the pulse Qi exceeds four times its normal strength, Yin Qi has reached its extreme. Yin Qi becomes obstructed, and fluids can no longer flow through. The Zhengli Lun says that this obstruction causes an inability to urinate. Here, “sou” means urination.

If both the Renying pulse at the neck and the Cunkou pulse at the wrist are more than four times stronger than usual, this is called “Guange”—a severe blockage of Yin and Yang Qi that prevents them from communicating with each other. When the Guange pulse reaches its utmost strength, the body can no longer adequately receive the vital essence of Heaven and Earth, and the person will eventually die.

“Both pulses are strong” means that the pulse at each of these two locations is more than four times stronger than usual. Nothing can remain at its peak indefinitely; once it reaches the extreme, it declines. Thus, the body can no longer bear the vital essence of Heaven and Earth, and the person dies. The Lingshu Jing says: “When Yin and Yang are both strong and cannot harmonize with each other, this is called Guange. Those who develop Guange die before reaching their allotted lifespan.” This is the condition being described.

The textual editor points out that “ying” should be read as “ying” meaning “full.” A pulse more than four times stronger than normal does not mean that it is merely “in excess,” but that it has reached its extreme. In classical texts, the characters for “surplus” and “fullness” can be used interchangeably.

The Heart corresponds to the pulse because Fire is active in nature and is connected with the pulse; since the Heart belongs to Fire, the Heart and pulse are associated. The Heart’s outward flourishing is reflected in the complexion: as Fire Qi rises, the face often appears red. The New Collation notes that Wang Bing’s explanation of the Heart’s flourishing as redness alone is incomplete. Any color or sheen visible on the face may be regarded as the Heart’s flourishing; it is not limited to redness.

The Heart is governed by the Kidneys. Here, “governed” means that one organ overcomes and restrains another: Fire fears Water, and the Kidneys belong to Water, so the Kidneys govern the Heart.

The Lungs correspond to the skin. Metal is firm by nature, and the skin, too, has a resilient quality. Since the Lungs belong to Metal, the Lungs and skin are associated. The Lungs’ outward flourishing is reflected in the hair, because hair grows from the skin. The Lungs are governed by the Heart: Metal fears Fire, and the Heart belongs to Fire, so the Heart governs the Lungs.

The Liver corresponds to the sinews. Wood can bend and straighten, and the sinews have the same qualities. Since the Liver belongs to Wood, the Liver and sinews are associated. The Liver’s outward flourishing is reflected in the nails, which are considered to grow from the residual Qi of the sinews. The Liver is governed by the Lungs: Wood fears Metal, and the Lungs belong to Metal, so the Lungs govern the Liver.