《黃帝內經素問補註釋文》Vol. 3

The Yellow Emperor said: Since ancient times, human beings have been connected with Heaven; this is the foundation of life. Life is rooted in Yin-Yang. Between Heaven and Earth, within the Six Directions—the four cardinal points and above and below—the climates of the Nine Provinces, the body’s nine orifices, its five viscera, and its twelve joints all connect with the Qi of Heaven.

Note: The Six Directions are above, below, and the four cardinal points. The Nine Provinces are Ji, Yan, Qing, Xu, Yang, Jing, Yu, Liang, and Yong. Spread across the outer world, the Nine Provinces correspond to the body’s nine orifices. The five viscera are also called the “five spirit-storing viscera”: the liver stores the ethereal soul, the heart the spirit, the spleen intention, the lungs the corporeal soul, and the kidneys resolve. In this way, the five viscera form the human body. The twelve joints refer to the twelve seasonal periods, which correspond to the body’s twelve meridians. Both the inner and outer worlds follow the patterns of Heaven’s seasons, so they are said to connect with Heaven’s Qi. The twelve meridians comprise three Yin meridians and three Yang meridians in each of the hands and feet. The New Corrected Edition explains that the passage “Communion with Heaven is the root of life” is discussed in detail in the commentary to “Treatise on the Six Seasonal Nodes and the Manifestations of the Viscera.” Zheng Xuan holds that the nine orifices consist of seven Yang orifices and two Yin orifices.

Human life operates on the basis of the Five Phases, and the Qi one receives comes in three kinds. Repeatedly violating these principles allows pathogenic Qi to injure the body. These are the foundations of longevity.

Note: The activities of human life are inwardly established through the Qi of the Five Phases. Living between Heaven and Earth, people also correspond to three kinds of Qi: the Qi of Heaven, the Qi of Earth, and the Qi of the movements of the heavens. “Violation” refers to pathogenic Qi invading the Qi of life. Repeated incursions by pathogenic Qi weaken the Qi of life. One should therefore cherish and nourish one’s innate, authentic Qi, making it the foundation of longevity. The Gengsang Chu says that the sage governs all things in order to preserve their nature; when their nature is preserved, their spirit is whole. The Jing of the Numinous Pivot says that blood and Qi are the basis on which the human spirit depends and must be carefully regulated and nourished. This is the principle being expressed.

When the Qi of the vast sky is clear and calm, people’s minds are at peace; by following its course, Yang Qi becomes secure.

Note: Spring corresponds to the azure sky and is the season when all things come forth and grow. Yang Qi is the Qi of Heaven. The “Treatise on the Correspondences of Yin and Yang” says, “Clear Yang forms Heaven,” expressing precisely this idea. By following the seasons of Heaven and preserving the spirit, the spirit remains whole and the body can likewise be preserved.

Even external pathogenic influences cannot harm a person. This is because they follow the proper order of the four seasons.

When people adapt to the seasonal changes in the weather, pathogenic influences cannot invade the body.

Thus, sages can preserve their spirit and follow the Qi of Heaven, thereby communicating with the divine.

Only sages who have attained the Dao can preserve and transmit the spirit. By nourishing the pristine Qi of Heaven—the natural, uncorrupted energy of life—for a long time, its wondrous effects arise of themselves, allowing a person to reach the divine.

If this state is lost, the nine orifices—the eyes, ears, nostrils, mouth, and the two lower openings—become blocked within. On the outside, the muscles become congested, while defensive Qi, which protects the body’s surface and warms and nourishes the muscles, becomes scattered and weak.

To “lose” this state means to go against Heaven’s law of quietude and clarity. Defensive Qi corresponds to Heaven’s Yang Qi. The Upper Chapter says, “Yang Qi becomes blocked.” This means that when Yang Qi is disordered, the body’s openings may leak or become blocked. The Ling Shu Jing says that defensive Qi warms the muscles, nourishes the skin, fills out the skin’s texture and pores, and governs the opening and closing of the pores. When defensive Qi does not circulate properly, the nine orifices become blocked and the muscles congested. Because defensive Qi cannot circulate normally, it is said to “scatter and disperse.”

This is self-inflicted harm, causing Qi to diminish day by day.

Going against Heaven’s Qi and violating the principle of quietude and clarity causes the body’s true Qi to dwindle, as if it were being cut away. This is not a calamity sent down by Heaven; people bring it upon themselves.

Yang Qi in a person is like the sun in the sky. When Yang Qi can no longer perform its proper function, life is shortened and vitality cannot flourish.

This further explains the role of Yang Qi described above: people have Yang Qi just as Heaven has the sun. When Heaven loses the sun’s radiance, daylight grows dim. When people lose Yang Qi’s protection, their Yang Qi can no longer remain secure. Without the sun’s light, the sky grows dark; without secure Yang Qi, people live shorter lives.

Therefore, the workings of Heaven depend on the sun’s light.

This means that human life depends on Yang Qi.

Thus, Yang Qi rises as the body moves and protects its outer surface.

This describes where Yang Qi circulates and its normal protective function in the body.

When exposed to cold, the body should move as though a pivot were turning within it, while daily activities and rest should not be abrupt or agitating.

“Like a pivot turning” means that movement should be measured and centered inwardly. “Daily activities and rest like a sudden alarm” means acting abruptly and hastily. The passage says that in cold weather one should remain sheltered and take careful steps to preserve health, like a pivot turning within. One should avoid overstraining the sinews and bones, which scatters Yang Qi to the skin’s surface and leaves the body vulnerable to cold pathogens. If one acts abruptly, rushes about, overexerts oneself, or gives free rein to excess, the spirit and Qi will become unsettled and rise outward, making it difficult to remain calm. The Treatise on the Essentials of the Pulse and Subtle Signs says, “In winter, the sun is…” The original text ends here.

The three months of winter are called “Closed Storage.” Water freezes into ice, and the earth cracks from the cold. At this time, do not disturb the Yang Qi within the body. The Treatise on the Regulation of the Spirit in Accordance with the Four Qi Seasons also says: Let the mind and will lie in concealment, as though hidden and held in reserve, as though something had already been gathered. Avoid the cold and seek warmth. Do not let the skin open and sweat, lest Qi be repeatedly depleted. This is what it means to preserve health in winter.

The Corrected Edition says that the version by Quan Yuanqi reads “Lian Shu.” Quan Yuanqi explains: “Yang Qi is settled like a connected pivot.” This means that Yang Qi is like a pivot joined to the body, sustaining its activity.

When illness arises from summer heat, sweating and agitation may be accompanied by panting and loud exhalations; when the person becomes calm, they may speak excessively. This happens because the person failed to remain calm and cautious, was invaded by cold in winter, and then developed a summer-heat illness in summer. Here, “agitation” means restlessness, “calm” means quiet, and “he” means loud exhalation. During an outbreak of summer-heat illness, sweating should disperse the pathogenic heat. If this does not happen, the pathogenic heat attacks inward, making the body hot inside and out. The person then becomes restless, pants rapidly, and exhales loudly. If there is no agitation, but internal heat and a cooler exterior, this indicates that accumulated pathogenic heat is attacking within; the person therefore speaks excessively and incoherently.

When the body is as hot as glowing charcoal, sweating can disperse the heat. This restates that fever can be relieved by inducing sweat: when the body is so intensely hot, sweat must be released for the heat to dissipate. Another version of the original text writes “zao” instead of “fan.”

When illness is caused by Dampness, the head feels as if wrapped in something, and the Damp-Heat cannot disperse. The large sinews contract and shorten, while the small sinews relax and lengthen. Shortened sinews cause spasms; relaxed, lengthened sinews cause weakness and wasting. An exterior-heat illness should ordinarily be dispersed through sweating. But if Dampness instead envelops the head, as though it were wrapped in something wet, the heat cannot subside, and Dampness also invades inward. Heat causes the large sinews to contract and shorten, while Dampness draws the small sinews out and lengthens them. The former causes the sinews and channels to spasm and lose their ability to extend; the latter causes the limbs to become weak and powerless.

When disordered Qi movement causes swelling, the body’s limbs, sinews, bones, flesh, and blood all take one another’s place in bearing the burden, and Yang Qi is exhausted. If Qi movement is already disordered, the addition of Damp-Heat causes Qi, Dampness, and heat to contend with one another, producing swelling. As the pathogenic Qi grows stronger, the upright Qi gradually weakens. Sinews, bones, flesh, and blood take turns bearing the harm; this is why the text says, “the four limbs take one another’s place.” The pathogenic Qi displaces the upright Qi and obstructs the flow of Qi. Defensive Qi, which protects the body’s exterior, can no longer circulate normally and is ultimately exhausted; hence the phrase, “Yang Qi is then exhausted.” The original passage continues beyond this point.

Yang Qi refers to the Yang Qi within the human body.

When a person’s Yang Qi is abundant, excessive strain and exertion can make it flare up and deplete the vital essence and Qi. If this condition builds up into summer, it may cause “cooking reversal” (jianjue, a disorder in which Yang Qi is intensely constrained and the flow of Qi surges upward).

Here people are again being cautioned not to let their daily routines suddenly fall out of balance, or to become excessively agitated and damage their Yang Qi. Too much strain leaves the sinews and bones exhausted and harms the spirit and Qi. It depletes the innate true Qi, causing the sinews and channels to become distended and the vital essence and Qi to dry up. The Kidney Qi is thereby damaged, and the Qi of the Bladder also becomes depleted. When summer comes, cooking reversal may occur. “Reversal” means that the flow of Qi has become disordered and turned back on itself. Its symptoms are described further below.

The Xin Jiaozheng quotes the Mai Jie: “Having little Qi and becoming easily angered is due to Yang Qi losing its harmony. When Yang Qi is out of balance, it cannot spread and rise normally. Liver Qi should flow freely, but when it does not, a person becomes easily angered. This condition is called cooking reversal.”

The patient loses sight and hearing, and the spirit becomes muddled and confused, as if a city were collapsing or floodwaters were rushing onward, impossible to stop.

When the Kidney is damaged, the Qi of the Bladder is also depleted. The Kidney channel connects internally to the ears, while the Bladder channel begins at the inner corner of the eye; this is why blindness and deafness occur. The patient cannot see or hear clearly, and the mind, will, sinews, bones, and digestive system are also thrown into disorder. The whole person feels dazed and distressed, unable to settle. This is one of the harms that may result from excessive sexual activity.

When a person’s Yang Qi is abundant, a fit of great anger can throw the body and the flow of Qi out of balance. Qi and blood then accumulate in the upper body, causing “striking reversal” (bojue, a reversal disorder brought on when Qi and blood surge upward and collide).

Here people are again being cautioned against unchecked joy and anger and excessive depletion of the body. Anger harms the Kidney and, in severe cases, can even cause the flow of Qi to break off. Great anger makes Qi surge upward, preventing Yang Qi from descending, while blood accumulates in the chest. “Above” refers to the chest. Yin and Yang collide, and Qi and blood surge together, producing striking reversal; hence the name.

The Discourse on Pain says that anger makes Qi rise and, in severe cases, can cause vomiting of blood. The Lingshu Jing says that unrelenting rage damages the mind. The Treatise on the Correspondences of Yin and Yang says that both joy and anger damage Qi. These passages show that excessive anger makes Qi surge upward and causes blood to accumulate in the chest. “Accumulation” here means stagnation.

When the sinews are injured, they become slack and weak, as though the body had lost its support.

Excessive anger and overexertion can force Qi against the sinews and channels, injuring them internally. The joints then lose control of their movement, the muscles become slack, and the body grows weak, as if it could no longer support itself.

If sweating occurs on only one side of the body, it may cause hemiplegia.

If one side of the body is persistently the only side that sweats and has moist skin, that side may, over time, become weakened and withered, making it difficult to move one half of the body.

If sweat meets Dampness after it is discharged, acne or heat rash may develop. When Yang Qi spreads outward and cold blocks it, heat becomes congested between the body and the skin. Severe congestion can form acne and boils; milder congestion produces heat rash. “Wind rash” refers to a type of rash that appears on the skin.

People who eat rich, fatty foods are prone to developing large boils. “Fatty and rich foods” refers to rich, sweet, and strongly flavored foods. If people who eat this way sweat and then are exposed to Dampness, they are prone to acne and heat rash. Because heat has accumulated inside them, their skin is thick and their muscles dense; pathogenic heat may become congested internally and give rise to boils. When external Dampness enters and combines with internal heat, pathogenic toxins can readily take advantage of the body’s vulnerability, as though one were holding an empty vessel out to receive something. Hence the phrase “receiving as if holding an empty vessel.” Commentators say boils often occur on the feet because the limbs are the foundation of Yang, and the feet are easily strained and exposed to pathogenic influences. The Revised Text, however, points out that boils do not occur only on the feet. The passage means that ailments caused by rich foods are more likely to produce large boils.

After sweating from physical labor, exposure to wind and cold allows cold pathogens to enter the skin’s interstices—the surface lines of the skin and the sweat pores. Sebum then congeals and collects in the pores, forming blackheads. These lie within the skin and may be shaped like grains of rice or pinpoints. Over time, their tips turn black; they are about one fen long, with a white-yellow color around them. Blocked in the pores, they are commonly called “blackheads.” Acne boils are red and swollen, with blood and pus inside; small ones are about the size of a Chinese jujube, while large ones are about the size of a bean. These conditions are all caused by Yang Qi becoming congested internally. Treatment should wait until the swelling softens; in severe cases, a fire needle may be used to puncture it and drain it.

When Yang Qi is abundant, it transforms refined substances and nourishes Shen (spirit); when it is gentle, it nourishes the sinews and vessels. This further explains how Yang Qi moves through and nourishes the body: inside, it transforms refined substances to nourish Shen; on the body’s surface, it keeps the sinews and vessels supple and strong. If activity and stillness are out of balance, various illnesses arise.

When the body’s opening and closing mechanisms fail to regulate properly, cold can take advantage of the weakness and invade, causing “dàlǚ”—a condition involving a bent back or stooped body.

The “opening” of the skin means that its interstices—the lines and pores between the skin—loosen, allowing sweat to escape. “Closing” means that the sweat gates shut and seal in the sweat. When opening and closing fall out of balance, cold can take advantage of the body’s weakness and penetrate deep within, making the sinews and vessels cold, tense, and rigid. The body may then become hunched and stooped. As the Lingshu Jing says, “When exposed to cold, the sinews and vessels contract.” This passage describes that kind of condition.

When cold sinks into the vessels, it can produce sores and fistulas that spread through the interstices of the flesh. “Cold sinking into the vessels” means that cold penetrates and injures the network vessels. If the cold remains lodged and does not disperse, blood flow through the channels slows and congeals. Over time, the stasis penetrates inward and gathers in the flesh, eventually forming sores and fistulas that connect with the surrounding interstices of the flesh.

If cold enters the transport points on the back—the points through which the Qi of the organs is conveyed to the back—and its Qi changes and penetrates deeply to press close to the organs, a person may become fearful and afraid, or even be startled.

When the movement of nutritive Qi, the refined Qi that circulates within the vessels, becomes disordered and runs counter to its course among the lines of the flesh, swellings and abscesses arise. As nutritive Qi flows in reverse, blood becomes stagnant. This stagnation causes heat to gather, which then turns to pus and forms an abscess. The Zhengli Lun says, “Wherever heat passes, abscesses arise.”

Before sweating has fully stopped, the body is already weakened and its Qi depleted. If wind and cold then attack, the sweat pores immediately close, trapping heat inside and preventing it from dispersing. In autumn, the autumnal Qi further contracts the pores. The heat within and the heat outside then combine, causing chills and alternating cold and fever. Because the illness is caused by wind, it is called wind malaria, a malarial-like cycle of chills and fever brought on by wind. The Jinkui Zhenyan Lun says, “When sweat does not flow freely in the summer heat, wind malaria develops in autumn.” The passage discusses an illness caused by wind. That is why it goes on to say, “Wind is the beginning of the hundred illnesses.” If one can remain calm and still, the interstices of the skin will close securely; even when struck by violent wind and fierce toxins, one is less likely to be harmed. This is the way of adapting to the changes of the four seasons.

To keep desires from exhausting the eyes, prevent improper influences from disturbing the heart, and avoid overexerting oneself is to remain calm and still. When body and mind are calm, the interstices of the skin close tightly, and upright Qi remains within to resist external influences, making it harder for deficient and harmful influences to enter. Yet violent wind and fierce toxins do not always seek people out; often, people bring themselves into contact with them. Calm and stillness keep the interstices closed and allow Yang Qi to resist external influences, making it difficult for wind and toxins to harm the body. Here, calm and stillness mean adapting to the climate of the four seasons and regulating one’s life according to the principles of health cultivation: avoiding needless exertion and keeping regular hours of rest and activity. In this way, life Qi is not depleted, and the body can remain healthy for a long time.

When illness has lasted a long time, pathogenic influences transform and spread among one another, and the movement of Qi between the upper and lower parts of the body can no longer communicate. Even a highly skilled physician has no way to treat it.

Here, “convergence” means that the movement of Qi communicates between the parts. When illness is severe and prolonged, the patterns of disease keep changing, communication between the upper and lower parts is blocked, and Yin and Yang are shut off from one another. What can even a highly skilled physician, with subtle methods, do then? The “Treatise on the Correspondence of Yin and Yang” says: “One skilled in acupuncture guides Yang from Yin and Yin from Yang; when the disease is on the right, treat from the left, and when it is on the left, treat from the right.” If the Qi of Yin and Yang repel one another, even the finest medical skill may not suffice. “Pi” means obstruction and lack of flow.

When Yang Qi accumulates and does not disperse, it causes illness and may even lead to death. When Yang Qi is blocked, it should be drained promptly. If treatment is delayed, an inept physician may make the condition worse.

This means that when the Qi of the Three Yang accumulates and stagnates, its movement is obstructed; if it is not drained in time, illness and even death may follow. Why? As the accumulation persists without dispersing, Qi can no longer flow between the upper and lower parts of the body. How can this be recognized? Signs include obstruction and difficulty passing urine or stool. If the blockage is not drained promptly, and a careless physician treats it lightly, the condition will inevitably worsen and may become life-threatening. The “Treatise on the Distinction of Yin and Yang” says: “When the Three Yang bind together, this is called ‘separation.’” It also says: “When strength contends with strength, Yang Qi is depleted and Yin Qi is lost; when Yin and Yang are out of harmony, the Qi in the channels is cut off.” Here, “Nao” refers to a loss of balance between the firm and yielding qualities of Yin and Yang.

Yang Qi governs the body’s outer activities throughout the day.

During daylight, Yang Qi circulates at the body’s surface, making twenty-five circuits through the whole body. The Spiritual Pivot says that when the eyes open, Qi moves upward to the head; defensive Qi, which circulates at the body’s surface and protects it, makes twenty-five circuits through the Yang aspect.

At dawn, Yang Qi begins to arise. By midday, it is at its strongest. As the sun declines in the west, Yang Qi has already begun to wane, and the Qi gates close along with it.

“Long” means high or flourishing. Yang Qi gradually increases from a low level until it reaches its full strength, like stored warmth turning into heat. When heat reaches its extreme, it becomes cool: this is how things change. The body’s Yang Qi follows the same pattern: it begins to arise at dawn, flourishes at midday, and gradually weakens at sunset. “Qi gates” refers to the Xuanfu, the fine channels spread across the body’s surface that discharge and diffuse Qi and blood. For this reason, they are also called Qi gates.

At night, therefore, Yang Qi should be gathered and protected. Do not strain the sinews and bones, and do not expose the body to mist and dew. Going against these principles leaves the body tired and weakened.

These practices follow the changes in Yang Qi: when it moves outward, a person should be moderately active; when it withdraws and is stored, a person should rest quietly. At night, Yang Qi wanes, turns inward, and moves through the Yin aspect, so it should be gathered to guard against invading pathogenic influences. Excessive exertion and strain on the sinews and bones deplete Yang Qi; exposure to mist and dew makes the body vulnerable to cold and damp. By following the changes across these three periods of the day, one can preserve the life Qi endowed by nature.

Qibo said:

The question-and-answer exchange here is not a dialogue between the Yellow Emperor and Qibo. Rather, Qibo continues explaining the subject from the preceding passage.

Yin can store essence and Qi and keep them circulating without interruption; Yang can guard the body’s exterior and make it firm. This passage describes the respective functions of Yin and Yang in the human body. “Frequently” means continually or repeatedly.

If Yin cannot restrain Yang, the pulse Qi may surge rapidly, and excessive Yang Qi may gather, causing a person to become delirious. “Rapid surge” refers to the pulse Qi moving hastily; “gather” means that Yang Qi is abundant and full. Here, “delirious” includes such behavior as running wildly and climbing recklessly. When Yang Qi gathers in the limbs, they become full and strong. The Treatise on the Yangming Channels says that the limbs are the foundation of the Yang channels. When Yang is abundant, the limbs are powerful, and a person may climb high and sing. When heat flourishes inside the body, the person may also take off their clothes and want to run about. These are all signs that Yin cannot overcome Yang.

If Yang cannot restrain Yin, the Qi of the Five Zang organs will contend with and disturb one another, and the nine orifices will become obstructed. The nine orifices correspond internally and externally with the Five Zang organs: when the Qi of the organs is out of balance, the orifices are affected. The nine orifices here include the anterior and posterior openings, as well as the seven openings of the head and face. More specifically, the eyes are the external orifices of the liver, the nose of the lungs, the mouth of the spleen, and the ears of the kidneys. The tongue corresponds to the heart, though the tongue itself is not an orifice. The Treatise on the True Words of the Golden Casket says that the red Qi of the south connects with the heart and opens into the ears, while the black Qi of the north connects with the kidneys and opens into the two lower openings.

For this reason, the sages clarified the principles of Yin and Yang so that the sinews and vessels would be coordinated, the bones and marrow strong, and Qi and blood able to flow freely. “Follow” means to accord with and flow smoothly. By following the principles of Yin and Yang and adhering to the way of nourishing life, the sinews and vessels, bones and marrow each function as they should, while Qi and blood respond to the seasons and circulate in harmony.

In this way, the body is balanced inside and out, and pathogenic influences cannot harm it. Hearing and sight remain keen, and the body’s healthy Qi continues to circulate as usual. Pathogenic influences cannot overcome healthy Qi, so it can maintain its normal state. If one goes against the sages’ teachings on nourishing life, the body will become ill. The following passage gives examples:

When wind enters the body and disrupts its healthy Qi, essence and Qi are depleted. This is a manifestation of pathogenic influence injuring the liver. The next few passages describe illnesses caused by going against the way of nourishing life. Wind corresponds to the liver; the Treatise on the Manifestations of Yin and Yang says, “Wind Qi connects with the liver.” When wind attacks, heat arises in its wake. Excessive heat depletes bodily fluids; when these fluids are insufficient, the kidney Qi cannot nourish the body properly, and essence and Qi are depleted. “Lost” means absent or depleted.

If pathogenic qi (qi arising from an imbalance or disorder between Yin and Yang) takes advantage of a deficiency, and wind pathogen also invades the body, Jing and qi will be damaged. Once Jing and qi are harmed, pathogenic qi will enter the liver.

If one then eats too much, the sinews and vessels will slacken and lose their restraint, and the intestines will develop diarrhea, leading in turn to hemorrhoids. Overeating causes the stomach and intestines to become distended; when they are distended, the sinews and vessels slacken and cannot connect and restrain things properly, so diarrhea and hemorrhoids result. The “Treatise on Impediment” says, “Eating and drinking twice as much as usual injures the stomach and intestines.” This is precisely the situation described here. (The character “bi” in pi sounds like “pi” meaning “secluded”; here it refers to ailments such as diarrhea.)

If one then drinks heavily, qi will surge upward. Drinking too much causes the lobes of the lungs to expand and rise, so qi rebels and rushes upward.

If one then forces oneself to exert effort, Kidney qi will be damaged, and the bones of the lower back will deteriorate. “Forcing oneself to exert effort” here means forcing oneself to engage in sexual activity; “high bones” refers to the bones in the upper part of the lower back. Forced sexual activity depletes Jing and qi, and their depletion harms the Kidneys. When the Kidneys are damaged, the qi of the bone marrow dries up from within. The bones of the lower back then deteriorate and can no longer support movement properly. The sages did not engage in sexual activity in this way. As explained below, they knew how to exercise restraint.

The key to harmonizing Yin and Yang lies in keeping Yang qi contained and not releasing it recklessly. When Yang qi is kept secure and is not casually dissipated, the qi of life becomes strong and stable, and the body can endure. This is the principle followed by the sages.

If Yin and Yang cannot unite at all, it is like a year with spring but no autumn, and winter but no summer. “The two” here refers to Yin and Yang; “harmony” means their union and interaction. Cutting off the way Yin and Yang unite is like losing seasons: it obstructs the growth and transformation of the myriad things. The sages therefore did not advocate ending the union of Yin and Yang. They valued keeping Yang qi secure and contained; this is the way to preserve innate true qi.

Sexual union should take place when Yang qi is flourishing and active, when inner and outer correspond, and when both spirit and physical strength are sufficient. This is the standard for union established by the sages.

Thus, if Yang qi is excessively strong but cannot be kept contained, Yin qi will be depleted and Jing and qi will weaken.

When Yin qi is balanced and Yang qi is secure, mental activity can remain normal and harmonious.

If Yin and Yang separate from one another, Jing and qi will be cut off. In other words, when Yin qi is not balanced and Yang qi cannot be kept contained, forcing oneself to act and depleting Jing and qi will damage innate true qi.

This scripture explains the pathological mechanisms of Yin-Yang imbalance in the human body and seasonal pathogenic factors:

When the body's true Yin and true Yang energies separate and meridian functions decline, Jing (essence) and Qi can no longer circulate properly, ultimately leading to the exhaustion of vital functions. For example, when exposed to wind during outdoor sleeping, external wind pathogens invade the body, triggering the body's Yang energy to resist. This conflict between vital energy and pathogens manifests as alternating chills and fever.

Spring wind pathogens, when retained, impair the Wood phase (liver system). Excessive liver Wood overacts on spleen Earth (digestive system), causing severe diarrhea (called "dongxie"). The commentary notes that the "Great Treatise on Yin-Yang Correspondences" mentions spring wind exposure leading to summer indigestion diarrhea ("sunxie").

Summer heat invasion leaves residual pathogens that clash with autumn's cooling energy, causing stubborn malaria ("jiēnüè") - with "jiē" indicating chronic, lingering cases.

Autumn's dampness from the earth, when ascending abnormally, induces coughing. When winter's Water phase (kidney system) dominates, rising water energy attacks the lungs, worsening cough. Internally, dampness attacking organs causes cough; externally invading sinews leads to muscular atrophy and weakness ("weijue"), with "jue" denoting reversed Qi flow.

Winter cold pathogens accumulating internally clash with spring's rising Yang energy, causing warm-natured diseases. The commentary references detailed explanations in the "Great Treatise on Yin-Yang Correspondences."

Abnormal seasonal climates sequentially damage the five organs: imbalanced alternation of cold, heat, warmth and coolness disrupts their harmonious state. While the body's Yin essence derives from five-flavored foods (sour, bitter, sweet, pungent, salty), the five organ systems are vulnerable to improper diets. Excessive sour food, for instance, causes liver Qi excess ("jin" indicates fluid retention), which suppresses spleen Earth function, leading to urinary difficulties and related disorders.

When fluids surge inward, they cause the lobes of the liver to rise. As the liver lobes rise, the Qi of the Spleen channel is cut off and can no longer flow. This is because Wood overcomes Earth: the liver belongs to Wood, and the spleen belongs to Earth.

Food that is excessively salty damages and exhausts the Qi within the large bones, tightens the muscles, and suppresses Heart Qi. Too much salt also makes the skin contract and causes Heart Qi to stagnate. This is because salty flavor enters the blood. The Qi within the large bones is damaged because salty flavor is associated with the kidneys.

Food that is excessively sweet makes Heart Qi rush and swell, darkens the complexion, and throws Kidney Qi out of balance. Too much sweet flavor causes inner agitation. Sweet flavor is sticky and moderating in nature, so it makes Qi rush and swell; it also disrupts the balance of Kidney Qi. This is because Earth overcomes Water. Here, “balance” means equilibrium.

Food that is excessively bitter deprives Spleen Qi of moisture, while making Stomach Qi thick and robust. Bitter flavor is drying and firming in nature, and it can also nourish the spleen and stomach. Thus Spleen Qi becomes insufficiently moist, while Stomach Qi grows strong and thick.

Food that is excessively pungent makes the sinews and vessels moist and relaxed, and prolongs the spirit. Here, “ju” means moist, “chi” means relaxed, and “yang” means prolonged. Pungent flavor is moistening in nature and can nourish the sinews and vessels, relaxing the sinews and moistening the vessels, thereby prolonging the spirit. This is because pungent flavor can supplement the liver. The Treatise on the Storage of Qi and Its Correspondence to the Seasons says: “The liver desires to spread outward; promptly eat pungent foods to disperse. Use pungent flavor to supplement it.”

The reviser of the New Collation argues that this chapter discusses the harm caused by eating too much of the five flavors, so it is difficult to interpret “prolonging the spirit” as a result of excessive pungent flavor. “Yang” should be “yang,” meaning “calamity”; the two characters were interchangeable in ancient texts. For example, “gaoliang” was written as “gaoliang,” and “caozi” as “caozi.” Ancient writing was concise and often used characters with similar forms, or characters that could stand in for one another.

Therefore, the five flavors should be carefully balanced. This keeps the bones aligned and the sinews and vessels supple, allows Qi and blood to flow freely, and keeps the interstices—the skin’s markings and the fine spaces between the muscles—tight. In this way, Qi and bone become strong and refined. By carefully following the way of nurturing life, one can enjoy the allotted span of life for a long time. This is the highest principle of cultivating one’s original nature and following the inherent course of life.