《黄帝内经灵枢略》

The Yellow Emperor asked, “When a person first begins to take form, what serves as the foundation? What is followed in adaptation? Losing what leads to death? Obtaining what allows survival?”

Qibo replied, “The mother is the foundation, and the father is that which is followed in adaptation. Losing Shen (spirit) and Qi (vital energy) causes death; obtaining Shen and Qi allows survival.”

The Yellow Emperor asked, “What is Shen (spirit)?”

Qibo answered, “When blood and Qi are in harmony, Yingqi (nutritive qi) and Weiqi (defensive qi) circulate freely, the five zang organs take shape, Shen-Qi settles peacefully in the heart, and both Hun (ethereal soul) and Po (corporeal soul) are fully present, only then does a complete human being come into existence. If the circulation of Yingqi and Weiqi remains within its proper measure, the six fu organs can digest grains, and the body fluids (jinye) can be distributed, a person can live a long life. Nothing within Heaven and Earth, in the four directions or above and below, exists apart from the Five Phases (Wood, Fire, Earth, Metal, Water); human beings correspond to them as well.”

The Yellow Emperor asked again, “What is meant by De (Virtue/Power) and Qi producing Jing (essence), Shen (spirit), Hun, Po, the heart, intention, will, thought, deliberation, and wisdom? Please explain the principle.”

Qibo replied, “What Heaven bestows upon humans is called De (Virtue/Power); what Earth bestows is called Qi (vital energy). When De and Qi interact, life arises. The beginning of life’s formation is called Jing (essence); the union of the parents’ Jing is called Shen (spirit). That which comes and goes following Shen-Qi is called Hun; that which accompanies Jing and enters and leaves the body is called Po. That which can receive external things and respond is called the heart; what is remembered in the heart is called intention; when intention remains steadily focused on a matter, it is called will; thinking through changes according to the will is called thought; further inferring distant or future matters from thought is called deliberation; after such deliberation, being able to handle affairs properly is called wisdom.

Therefore those who understand how to nourish life must follow the changes of the four seasons and adapt to cold and heat; they must harmonize joy and anger so that daily life remains stable; they must regulate Yin-Yang activity so that firmness and softness are coordinated. When this is accomplished, pathogenic Qi cannot easily invade, and one can live long while preserving vitality.”

Qibo said, “Blood, Qi, and Shen form the foundation that maintains life and connects a person’s innate endowment with longevity. The meridians circulate blood and Qi, coordinating Ying-Wei with Yin-Yang, nourishing the sinews and bones, and making the joints flexible. Weiqi warms and nourishes the nails and muscles, fills the skin, saturates the striae (the interstices of the skin), and regulates opening and closing. A person’s will and intention govern Shen, gather Hun and Po, enable adaptation to cold and warmth, and harmonize joy and anger.

Thus when blood and Qi are harmonious, the meridians flow freely, Ying-Wei and Yin-Yang are coordinated, the sinews and bones are strong, and the joints are agile. When Weiqi is harmonious, the nails and muscles are comfortable and supple, the skin is in good condition, and the striae are dense. When will and intention are harmonious, Shen remains focused and clear, Hun and Po do not scatter, regret and anger do not readily arise, and the five zang organs are not easily disturbed by pathogenic Qi. When cold and warmth are appropriate, the six fu organs can digest grains and distribute fluids, wind pathogens and Bi obstruction (blockage of meridians causing pain, numbness, and stiffness in the limbs) do not easily occur, the meridians remain unobstructed, and the joints of the four limbs move freely. This is the body’s normal, balanced state.

The five zang organs store Shen, blood and Qi, Hun and Po; the six fu organs digest water and grain and circulate jinye. These are all constituent parts that the human body receives from Heaven and Earth.”

Qibo continued, “Only when both aspects of Yin-Yang become excessive does pathogenic Qi readily linger. Pathogenic Qi enters from the body surface and at first has no fixed lodging place. Even when it disturbs the five zang organs it need not settle in one location but may travel with the Ying-Wei circulation. This renders Hun and Po restless and Shen-thought floating, causing uneasy sleep and frequent dreaming.”

The Discourse on the Six Qi describes how Jing (essence), Qi (vital energy), Jin (thin fluids), Ye (thick fluids), Xue (blood), and Mai (vessels) form and circulate in the human body. It also explains the connections among the zang-fu organs, meridians, and the sensory orifices, as well as how pathogenic Qi causes disease and how yongju—suppurative swellings between skin and flesh—take shape. The original text contains many repetitions; what follows consolidates them by content.

The Yellow Emperor asked: I have heard that the human body possesses Jing, Qi, Jin, Ye, Xue, and Mai, and I had supposed they were all one Qi. Now they are distinguished by six names, and I do not understand the differences among them. Please tell me what Jing is.

Qi Bo replied: When the Jing-Qi of father and mother unite, they form the physical body. Jing exists before the body itself, and this is Jing. The Yellow Emperor asked what Qi is. Qi Bo said: The Upper Jiao—the region above the diaphragm, associated with respiration and the movement of Qi—disseminates the refined essence of food and drink, warming and nourishing the skin, filling out the body, and moistening the hair, just as dew irrigates plants. This is Qi. He asked what Jin is. Qi Bo said: The fluids among the skin textures are discharged outward as sweat; this is Jin. He asked what Ye is. Qi Bo said: When the refined essence transformed from food and drink is abundant, it moistens the bones and joints so that they flex and extend freely, nourishes the brain marrow, and moistens the skin; this is Ye. He asked what Xue is. Qi Bo said: The Middle Jiao—the region between chest and abdomen, associated with digestion and absorption—takes substances from the refined essence of food and drink and, through transformation, produces red blood. He asked what Mai is. Qi Bo said: The Mai constrain and guide Ying Qi (nutritive Qi) so that it travels along the vessel pathways; this is Mai.

When one exhales, Qi moves outward; when one inhales, Qi moves inward. The body is nourished by the Jing-Qi of heaven and earth, and the intake of food and drink is likewise essential for maintaining the strength of Qi. Thus if one does not eat for half a day, Qi weakens; if one does not eat for a full day, Qi becomes still less. The Upper Jiao disseminates like mist, the Middle Jiao transports and transforms like irrigation channels, and the Lower Jiao—the lower abdomen, associated with excretion and the movement of fluids—drains like waterways.

The Yellow Emperor asked where Ying Qi and Wei Qi (defensive Qi) come from and how they circulate. Qi Bo said: Ying Qi issues from the Middle Jiao, Wei Qi from the Upper Jiao. Of the refined essence transformed from food and drink, the clearer portion becomes Ying Qi and the more turbid portion becomes Wei Qi. Ying Qi travels within the vessels, Wei Qi outside them. Ying Qi circulates without pause, completing fifty circuits each day before reuniting; Yin-Yang interpenetrate and the cycle begins again. Wei Qi travels twenty-five circuits in the Yin aspect and twenty-five in the Yang aspect, corresponding to night and day: when it moves in the Yang aspect a person is awake and active; when it moves in the Yin aspect a person sleeps and rests.

The function of Ye is to infuse Jing-Qi and moisten the body’s orifices. If the fluids of the eyes leak outward without cease, Ye is exhausted; when Ye is exhausted, Jing-Qi can no longer nourish the eyes and sight is eventually lost.

The five zang store and nourish a person’s Shen (spirit), Qi, Hun (ethereal soul), and Po (corporeal soul). The six fu receive food and drink, transmit and transform them, and distribute the Qi they produce. The meridians carry blood and nourish the whole body. These three work together to sustain bodily function. In a healthy person, when the stomach is full the intestines are relatively empty; when the intestines are full the stomach is relatively empty. This alternating filling and emptying of stomach and intestines allows Qi to pass up and down, the five zang to remain settled, the blood vessels unobstructed, and the person’s Shen stable. The “Shen” spoken of here is the spiritual activity nourished and sustained by the Jing-Qi of food and drink.

Pathogenic Qi produces different signs according to where it lodges. When it invades higher regions it is called “pathogenic Qi in the upper”; when irregular diet and disordered cold and heat damage the abdomen and stomach it is called “turbid Qi in the middle”; when clear-damp earth Qi invades from the feet it is called “clear Qi in the lower.” When Yin-Yang are out of balance, cold and heat contend, and pathogenic Qi struggles with the body’s Zheng Qi (upright Qi), suppurative abscesses may form.

A person obtains Qi from food and drink. Food and drink enter the stomach, the root of the transformation of water, grain, Qi, and blood. The refined essence produced by the stomach disseminates outward like mist; within the body it becomes Qi and blood and travels along the jing-sui, the pathways of the meridians that link the five zang and six fu. Each fu pairs with a zang: the lung with the large intestine, which governs transmission; the heart with the small intestine, which receives and transmits; the liver with the gallbladder, whose stored contents are relatively clear; the spleen with the stomach, which receives the five grains; the kidney with the bladder, which stores fluids. The Shaoyin meridian belongs to the kidney; kidney Qi connects upward with the lung, so kidney, lung, and the movement of Qi are interrelated. The Sanjiao—the Upper, Middle, and Lower Jiao together—is the passageway for fluids. These are the pairing relations of the six fu with the zang.

The functions of the five zang also communicate with the orifices of the head and face. Lung Qi communicates with the nose, which, when functioning normally, distinguishes odors. Heart Qi communicates with the tongue, which distinguishes the five flavors. Liver Qi communicates with the eyes, which distinguish colors. Spleen Qi communicates with the mouth, which distinguishes the flavors of grain. Kidney Qi communicates with the ears, which hear the various sounds. When the five zang are disordered, the orifices are affected; when the six fu are disordered, Qi, blood, and food stagnate and swellings may form.

When pathogenic Qi lodges in the fu, the Yang meridians become obstructed, Qi stagnates, and Yang Qi becomes excessive. Excessive Yang Qi in turn impedes the Yin meridians, so Yin Qi stagnates and becomes excessive. When Yin and Yang can neither communicate nor nourish each other, the condition is called guan-ge (blockage and rejection). The ancients held that once guan-ge appears, life can scarcely reach its natural span.

The Yellow Emperor asked why Qi seems to circulate only through the five zang and not to nourish the six fu. Qi Bo replied: Qi cannot cease circulating, any more than water can stop flowing or the sun and moon stop moving. The Yin meridians nourish the five zang, the Yang meridians nourish the six fu, cycling without end. Surplus circulating Qi also infuses inward into the zang-fu and moistens outward the textures of the skin.

The heart is the sovereign of the five zang and six fu and the dwelling place of Shen. When the heart is firm, pathogenic Qi cannot easily invade; if it does invade and damage the heart, Shen scatters and the person dies. Remaining in stillness, gathering the heart-Shen, and unifying the mind keep Hun and Po from dispersing and Jing-Qi from being depleted. This passage shows how greatly the ancients valued quiet cultivation and the gathering of spirit.

The Yellow Emperor asked why the same meridian can produce more than ten kinds of illness—pain, swelling, cold, heat, itching, numbness, and so on. Qi Bo said: All of these are caused by pathogenic Qi. Zhen Qi (true Qi) is the life Qi received from heaven and earth and combined with the Qi transformed from food and drink. Zheng Feng (proper wind) blows from the normal direction; it is not strong and is not a deficient pathogen that injures people. Pathogenic Qi generally refers to factors that invade by taking advantage of bodily weakness. Proper wind invades shallowly and recedes of itself after combining with Zhen Qi; deficient pathogens invade more deeply and do not readily leave.

When a deficient pathogen invades, a person feels cold, the body trembles, the hairs stand on end, and the skin textures open. If the pathogen reaches the bones it may form bone bi—pain and impaired movement of bones and joints. If it enters the vessels, blood circulation is obstructed and swellings form. When it enters the interior and contends with Wei Qi, predominance of Yang Qi produces heat and predominance of Yin Qi produces cold. If Zhen Qi is damaged and cold lodges between the skin layers, the opening and closing of the textures become irregular and numbness and other sensory abnormalities appear. If a deficient pathogen favors one side of the body, penetrates deeply, and damages Ying and Wei, Zhen Qi gradually declines while the pathogen remains, producing pianku—hemiplegia or dysfunction of one side.

After food and drink enter the intestines and stomach, the Qi issuing from the Upper Jiao warms the muscles and joints and opens the skin textures. The Qi issuing from the Middle Jiao, like dew, is distributed to the body’s valley-like regions and then seeps into the meridians. When Jin-Ye are harmonized they transform into blood. Blood first fills the meridians, then flows into the collaterals, and thereafter nourishes joints and skin. Ying and Wei Qi circulate with the breath in a regular cycle corresponding to the movements of heaven and earth. In treatment one regulates according to deficiency and excess: draining methods reduce surplus Qi in excess patterns; tonifying methods replenish what is insufficient in deficiency patterns. When blood and Qi are harmonized, form and Shen remain stable.

The Yellow Emperor further asked how yongju arise, when they worsen, and whether one can judge life or death. Qi Bo replied: The meridians circulate without cease, corresponding to the laws of heaven and earth. When heavenly Qi is disordered, the sun and moon are obscured, or the waterways of the earth overflow, the growth of all things and the lives of people are affected; the circulation of human blood and Qi likewise follows corresponding laws. Cold Qi lodging in the meridians causes the blood to congeal and become obstructed. Wei Qi gathers at the site of obstruction and cannot resume normal movement, forming swellings. Cold, long stagnant, transforms into heat; exuberant heat corrodes the flesh and produces pus. If the pus cannot be discharged it further damages sinews and bones: rotting sinews injure bone, injured bone damages marrow; once marrow is damaged the skeleton becomes empty, the spaces among sinews, bones, and flesh lose nourishment, and the meridians deteriorate. If the disease continues it injures the five zang and ultimately endangers life.

The Jing (essence) and Qi (vital energy) of the five zang viscera and six fu bowels all ascend to the eyes, where they gather to form the essential radiance within them. The eyes are the place where the Jing-Qi of the five zang and six fu converge; they are also the site regularly nourished by Ying Qi, Wei Qi, and the hun and po souls. A person’s Shen-Qi likewise becomes visible here. Therefore, when Shen-Qi is excessively depleted by overwork, the hun and po scatter and the mind’s resolve becomes disordered.

The pupil and the black iris correspond to Yin, while the white of the eye and the red blood vessels within it correspond to Yang. Only when Yin-Yang circulate in coordinated harmony do the eyes become bright. The eyes are governed by the heart-spirit; the heart is the dwelling place of Shen-Qi. If Shen-Qi is scattered, the gaze grows chaotic and dull, unable to turn nimbly. When a person suddenly sees an unusual sight, the Shen and the hun-po may disperse and fail to coordinate with each other, giving rise to bewilderment.

The Yellow Emperor asked: “Why are people prone to forgetfulness? What change of Qi produces this?” Qibo replied: “When Qi in the upper body is insufficient and Qi in the lower body is excessive, the intestines and stomach are full while the heart and lungs are weak. When the heart and lungs are weak, Ying Qi and Wei Qi stagnate below and for a long time cannot ascend at the proper time, so people easily forget.”

Ying Qi is the Qi that circulates inside the vessels; Wei Qi mainly circulates outside the vessels. Together they nourish and protect the body.

Treatise on Soundlessness

The Yellow Emperor asked, “When a person suddenly cannot speak because of sorrow or anger, where is the obstruction and which Qi (vital energy) cannot circulate, so that no sound can be produced? Please explain the principle involved.”

Shaoshi replied, “The pharynx is the passageway for food and drink; the larynx is the channel through which Qi moves up and down; the epiglottis is the gateway that produces sound; the lips function like the door-leaves of the voice; the tongue is the key to vocalization; the uvula (the small piece of flesh hanging at the back of the oral cavity) is the pass for sound production; the yansang (the nasopharyngeal region as described by the ancients) is the place where Qi is divided and expelled; and the henggu (here referring to the skeletal structure related to movement of the tongue) is governed by the activity of Shen (spirit) and controls the motion of the tongue.

Therefore, if the nasal cavity continually runs with mucus that cannot be stopped, it is because the yansang has failed to close, so that the division and outflow of Qi become disordered. When the epiglottis is small and thin, Qi is emitted quickly, opening and closing are agile, and Qi emerges easily; when the epiglottis is large and thick, opening and closing are difficult, Qi emerges slowly, and speech therefore becomes heavy and drawn out. What is called stuttering is simply this heavy, repetitive manner of speaking.

If one suddenly loses the ability to produce any sound at all, cold Qi has invaded the epiglottis and rendered it unable to move normally; sound cannot reach the key sites required for vocalization, so the lips and related structures cannot open and close smoothly, and the voice is thereby lost.”