《黃帝內經素問補註釋文》Vol. 9

"The Yellow Emperor asked: 'I have heard that Heaven forms a year according to the Six-Six Joints (liuliu zhi jie), the regulated cycle formed as six sexagenary cycles follow one another, and that the human body is formed according to the Nine-Nine Convening (jiujiu zhi hui), in which nine serves as the period that governs and gathers. The human body also has three hundred and sixty-five joints, which correspond to Heaven and Earth. This view has been passed down for a long time, but I do not know what it precisely means.'

Qi Bo's commentary says: 'The Six-Six Joints are the regulated cycle that forms a year once six sexagenary cycles are complete. The Nine-Nine Convening uses the number of the nine regions that cover the nine fields (the nine divisions of space recognized by the ancients) to govern the convergence found throughout the human body. That the body's three hundred and sixty-five joints correspond to the Six-Six Joints of Heaven has a long history. If, however, one also takes Nine-Nine as the principle for counting periods, then a cycle would take more than two years, and I do not know on what basis such a calculation rests.'

The Newly Collated Supplement notes that Wang Bing's annotation says, "Two years and a bit more than half a year make one cycle." Calculated by the Nine-Nine Convening, it should instead be "two years and one quarter of a year make one cycle."

Qi Bo replied: 'You have asked a penetrating question! Allow me to explain further. The Six-Six Joints and the Nine-Nine Convening are used to determine the measure of Heaven (tian du) and the number of Qi (qi shu). The Six-Six Joints concern the measure of Heaven, and the Nine-Nine Convening concerns the number of Qi.

The number of Qi refers to the Qi through which all things are generated and transformed. The circuit of Heaven is three hundred and sixty-five and a quarter degrees. Divided evenly among the twelve seasonal periods, this gives three hundred and sixty days. Adding the small months still leaves the days short. Therefore, sixty-four Qi must be arranged, and intercalary months must be set regularly. Why is this done? Because the accumulated days produce a discrepancy.

Heaven and Earth give birth to the myriad things, and the root of this lies in Yin and Yang. The activity of the human spirit, its movement and its beginning and end, takes the nine Qi as its starting point. Is the function of nine not a great one? The Treatise on Pitch-Pipes says: the Huangzhong pitch pipe is nine cun long, and on the day of the winter solstice, the seasonal Qi resonates with the pipe, and the ash within it flies up. From this we can see that the generation of the myriad things is related to the nine Qi.

The nine cun of the ancients, converted into today's measure, is about seven cun and three fen. The difference in size arose because the standard millet grain (black ju millet) used in the original establishment of measurements differed.

The measure of Heaven is used to determine the movements of the sun and moon. The number of Qi is used to record……'"

This is the principle by which huasheng (transformation and generation) operates. Zhi refers to the measure of standards, and ji refers to the guiding threads. Measuring the movements of the sun and moon against these standards makes it possible to determine how quickly or slowly they move. Using the guiding threads to explain how huasheng operates shows that when the climatic seasons arrive, the myriad things respond in step. When the response between climate and the myriad things is without error, the regularity of growth and transformation does not cease. From the speed of the sun and moon's movements one can calculate which months are longer and which are shorter. Days vary in length from one to the next, the succession of months brings changes of cold and heat, and the storing and growing of the myriad things each keep their proper seasons, none losing their due order.

Heaven is Yang and Earth is Yin; the sun is Yang and the moon is Yin. The movements of the sun and moon each have their limits and guiding threads, and their circuits around the celestial sphere also follow regular patterns. The sun moves one degree each day, while the moon moves a little over thirteen degrees each day, which is why there are longer and shorter months. After 365 days a year is complete. When the remainders accumulated from the solar terms exceed a certain limit, an intercalary month is formed.

The sun moves slowly, so between day and night it covers only one degree of the celestial sphere. After 365 days it completes one circuit of the heavens, yet it still has some degrees and fractions left over. The moon moves faster, so between day and night it covers a little over thirteen degrees, and it completes a circuit of the heavens in twenty-nine days. When the text says the moon moves "a little over thirteen degrees" each day, the "a little over" means that beyond thirteen degrees it advances a further seven nineteenths of a degree.

The Liyi and the Hanshu (Book of Han) treatise Lüli zhi (Treatise on Harmonics and the Calendar) state that the twenty-eight lunar lodges (ershiba xiu, the twenty-eight star regions into which Chinese astronomy divides the sky) and the other stars all set out from the east and travel westward along the celestial sphere, while the sun, the moon, and the five planets (wu xing) set out from the west and travel eastward along it. The taishi (the official in charge of astronomy and the calendar) now says that all the heavenly bodies move eastward, that is, they set out from the east and turn toward the west.

Calendrical experts commonly say that from the first to the fourth day of the month the moon moves fastest, over fourteen degrees a day. From the fifth to the eighth day it moves a little more slowly, a little over thirteen degrees a day. From the ninth to the nineteenth day it moves more slowly still, a little over twelve degrees a day. From the twentieth to the twenty-third day it speeds up slightly, to a little over thirteen degrees a day, and from the twenty-fourth day to the end of the month it moves faster again, over fourteen degrees a day. The taishi's account of the moon's speed, however, is not like this.

The moon's motion is sometimes faster in the first half of the month and slower in the second, and sometimes slower in the first half and faster in the second. Broadly speaking, a month can be divided into four stages, and each stage has its own variations in speed. The degrees of the moon's speed were never fixed to a single standard to begin with. Even so, the moon still completes a circuit of the heavens in twenty-seven days, and in total it travels 361...

The moon takes twenty-nine days to complete a cycle, moving roughly twenty-nine degrees a month. It covers three hundred and eighty-seven degrees and still lacks seven degrees to catch up with the sun. By the thirtieth day, continuing to reckon by the difference between the sun's and moon's motions, the moon catches up with the sun at about eight-thirteenths of a month. This is the case of a large month (dayue). Broadly speaking, reckoning the difference to one-half of one-thirteenth also gives a large month, while a reckoning that reaches five or six-thirteenths before the moon catches up with the sun gives a small month (xiaoyue).

Large and small months together total three hundred and sixty-five days, making up one year. Strictly speaking, a year is three hundred and sixty-five and one-quarter days, and because the remainder is less than a full day, it is expressed as a fraction. If six small months are counted together, a year has only three hundred and fifty-four days, about eleven days short of the actual year. When the time lost in each month is added to the surplus days beyond the year, the surplus accumulates to thirty-two days after the intercalary month is set, and another intercalary month is needed. The Book of Documents (Shangshu) says: "A cycle has three hundred and sixty-six days; intercalary months are set to calibrate the four seasons, completing the reckoning of the year." This is the principle at work. The remainder accumulates until intercalation is required because months are counted as large or small, and so cannot exactly match the degrees of celestial motion.

At the beginning of the year, the starting point of the solar terms is fixed; at mid-month, the position indicated by the Dipper handle is marked; at year's end, the accumulated remainder is reckoned. In this way, the degrees of celestial motion can be fully computed.

"Duan" means starting point, and "shi" means the beginning of the year. "Biao" means to mark, "zheng" means to fix the direction the Dipper handle points, and "zhong" means mid-month. "Tui" means to advance or adjust, and "zhong" (end) means year's end. That is, the starting point of the solar terms is set on the first solar-term day, the Dipper's direction is marked at mid-month, and after the full moon the accumulated remainder and the intercalary month are adjusted. Therefore, before intercalation the solar terms lag behind the months, and after intercalation the months lag behind the solar terms.

In the usual arrangement of months, the starting point of the solar terms is fixed at the beginning of the month, and the Dipper's position is fixed at mid-month. An intercalary month has no fixed beginning or middle. Even when the calendar marks solar terms within an intercalary month, those terms are simply other solar terms. For this reason, almanacs do not speak of "the solar term of the intercalary month" or "the mid-point of the intercalary month." From this it is clear that "reckoning to year's end" means adjusting the accumulated remainder at year's end. Reckoning dates and fixing intercalary months in this way completes the computation of the degrees of celestial motion.

The Yellow Emperor (Huangdi) said: "I have already understood the degrees of celestial motion. I wish to hear how the numbers of qi (qi) agree with them." Qi Bo replied: "Heaven is divided into nodes by sixes and sixes, and earth is governed and gathered by nines and nines." [New Collation] notes: "Looking closely at the opening of this chapter, the original text reads 'humans are governed and gathered by nines and nines.'"

Heaven has ten Heavenly Stems (tiangan). Sixty days complete one cycle of the Jiazi sexagenary cycle, and six such cycles make up a year, which is reckoned at 360 days.

The "ten days" refers to the ten Heavenly Stems: Jia, Yi, Bing, Ding, Wu, Ji, Geng, Xin, Ren, and Gui. The Appended Remarks (Xici) of the Yijing (Book of Changes) states that "Heaven's number is nine and earth's number is ten," and the "ten" here carries this sense. Sixty days complete one Jiazi cycle, and six cycles give the 360 days of the year. This is the calendrical year, not the actual period of the heavenly bodies. The reckoning assumes twelve months of thirty days each; if short months are subtracted, the day count will differ.

Since antiquity, those who understood the Dao (the Way) have known that the root of life lies in its connection with Heaven, and that this root is grounded in Yin-Yang. The people of the nine regions of the land have nine orifices in their bodies, and each of these is connected with the qi of Heaven.

The "connection with Heaven" here refers to primordial qi (yuanqi), which is also true qi (zhenqi). The human body is formed by relying on the earth, while life is bestowed by Heaven, so the breath that sustains life connects with Heaven and takes Yin-Yang as its foundation. The Baoming Quanxing Lun (Discourse on Preserving Life and Form) says: "Humans are born from the earth and their lives are suspended from Heaven; when the qi of Heaven and earth unite, this is called a human being." The Siqi Tiaoshen Dalun (Great Treatise on Regulating the Spirit According to the Four Seasons) also states that Yin-Yang and the four seasons are the patterns by which all things grow and end, and the root of life and death; violating this root injures the foundation of life and destroys true qi. The nine regions are Jizhou, Yanzhou, Qingzhou, Xuzhou, Yangzhou, Jingzhou, Yuzhou, Liangzhou, and Yongzhou. Because the land is divided into nine regions and the person has nine orifices, the human spirit and breath move in response to Heaven and earth, which is why the nine regions and nine orifices are both said to connect with the qi of Heaven. The Lingshu Jing (Spiritual Pivot) also says: "The earth has nine regions, and the human body has nine orifices." The text speaks of qi first because the true qi of Heaven is always held within the person. As long as the qi of Heaven is unbroken, the true spirit remains guarded within; a person's movement and stillness, and all of their inner functions, correspond to Heaven.

Therefore, the human form is produced by the circulation of the qi of the Five Phases (Wood, Fire, Earth, Metal, Water), while the source of life is generated by three kinds of primordial qi. Hence the saying "its generation is five, and its qi is three."

The "three" here also corresponds to the Three Primes (sanyuan). The collators of the Song-dynasty text (Xinjiaozheng) note that the passage from "those in antiquity who connected with Heaven" to this point is the same as the Shengqi Tongtian Lun (Discourse on Vital Qi Connecting with Heaven), though the commentary differs slightly, and the two should be read side by side.

Heaven is constituted by three elements, earth is constituted by three, and humans are constituted by three as well. It is not only humans who rely on three kinds of qi for their existence; the way in which Heaven and earth generate things is likewise.

Therefore, the hexagrams of the Yijing, including Qian and Kun and all the others, must each take "three" (san) as their basic structure.

Three multiplied by three makes nine. Spread out, these nine become the nine fields (jiuye), a division of heaven and earth into nine regions, and the nine fields correspond to the nine zang (the nine internal organ systems of the human body).

The nine fields are the explanation used to match the nine zang. The Erya says: "Beyond the city walls is called the jiao (suburb), beyond the suburb is called the dian, beyond the dian is called the mu (pasture), beyond the pasture is called the lin (forest), beyond the forest is called the jiong (outlying wilds), and beyond the jiong is called the ye (wilderness)." This describes exactly this kind of outward, layered division. Editorial note from the Xin Jiaozheng (New Collation): in the Erya as it survives today, the sequence reads "Beyond the city walls is called the jiao, beyond the jiao is called the mu, beyond the mu is called the ye, beyond the ye is called the lin, and beyond the lin is called the jiong." This differs from the version Wang Bing quoted.

Accordingly, there are four form stores (xingzang) and five spirit stores (shenzang), which together make nine and correspond to the nine fields. The four form stores are: first, the head and horns; second, the ears and eyes; third, the mouth and teeth; and fourth, the chest. They are distributed on the outside of the body, which is why they are called form stores. The five spirit stores are: first, the liver; second, the heart; third, the spleen; fourth, the lungs; and fifth, the kidneys. They are hidden within the body, which is why they are called spirit stores. As for the spirit stores, the liver stores the hun (ethereal soul), the heart stores the shen (spirit), the spleen stores the yi (intention), the lungs store the po (corporeal soul), and the kidneys store the zhi (will). The names and divisions of these two categories of stores differ from one another. Editorial note from the Xin Jiaozheng: on close examination, this passage comes from the chapter "Xuanming Wuqi Pian" and repeats the commentary to the "Shengqi Tongtian Lun" and also to the "Sanbu Jiuhou Lun." The concepts of form stores and spirit stores are explained in the commentary to the "Sanbu Jiuhou Lun."

The Yellow Emperor (Huangdi) said: "I have already heard of the pairing of the six-sixes and the nine-nines. You, Master, also said that when qi accumulates it fills the surplus remainder. I wish to ask what is meant by qi. Please set out the essentials and resolve my doubts."

The meaning of this sentence is: please ask Qibo to state the key points, open up principles not yet heard, dispel doubts, and give answers to those whose minds are confused, so that those who are benighted understand clearly and all may comprehend thoroughly.

Qibo said: "This is the learning of the rulers of high antiquity, kept secret and never transmitted openly. It was passed down to me by my former teacher."

The "Shangdi" mentioned here refers to the rulers of high antiquity. The former teacher Qibo speaks of was his ancestral master, Jiudaiji. Jiudaiji was a master of high antiquity skilled in observing complexion and taking the pulse. The Treatise on Shifting Essence and Changing Qi (Yi Jing Bian Qi Lun) says that in ancient times Jiudaiji was made to examine complexion and observe the pulse, in order to understand the principles of spirit. The Preface to the Eight Su Jing (Ba Su Jing Xu) records that the Celestial Master told the Yellow Emperor: "I have studied complexion-reading and pulse-taking from Jiudaiji for three generations." This shows that the related learning could be transmitted. Editorial note from the Xin Jiaozheng: on close examination, one edition writes the character su as "suo," and some hold that the "ba" in "Ba Su" should be "da" (great). However, no such passage appears in the current text of the Taisu. The character "jiu" in Jiudaiji is read as "jiu."

The Yellow Emperor said: "Please, Master, continue the account."

"Sui" means "exhaust," and here it asks Qibo to set out the principles completely.

Qibo said: five days make one hou (in ancient times, a five-day climatic period); three hou make one Qi; six Qi make one season; the four seasons together make one year. The climate of each season and each year is governed by the corresponding governing Qi.

The sun moves five degrees in the sky, approximately five days, so five days make one hou; three hou are exactly fifteen days, making one solar term; six Qi total ninety days, exactly three months. If time is divided more finely, eighteen hou combine into six Qi, and six Qi are called one season. The four seasons total three hundred and sixty days, so the four seasons together are called one year. “Each follows its governing rule” means that every day of the year belongs to one of the Qi of the Five Phases and is governed and activated by it. Therefore the following text says that the Five Movements (the patterns by which the Qi of the Five Phases moves and changes) succeed one another in turn, each governing its season; when the end of the year is reached, the cycle completes one revolution and begins again. The establishment of the four seasons and the distribution of the six Qi are like a ring without end, and the changes of the hou follow the same principle. Thus, one who does not understand how the seasons change each year, nor understands the origins of climatic abundance and decline, deficiency and excess, cannot be called a good physician.

The Five Movements refer to the Qi of the Five Phases responding to the seasons and governing the transformations of the myriad things. Here “xi” means to succeed or inherit, as when direct descendants inherit the family estate. The Qi of the Five Phases succeed one another in order, take turns governing the movement of the year, and cycle back and forth without cease.

“Times are established” refers to the time before spring begins, when the season should arrive; “Qi is distributed” means that the pulse Qi corresponding to the governing Qi also appears accordingly. Before spring arrives, the corresponding pulse Qi also appears, hence “times are established and Qi is distributed.” “Hou” refers to the five-day period corresponding to the sun’s movement of five degrees. Within each hou, the Qi of the Five Phases also generates in sequence and takes turns on duty; if the rhythm deviates, illness may result. The “Treatise on Heavenly Truth in High Antiquity” says that the physicians of high antiquity, such as Jiudai Ji, could examine complexion and pulse, comprehend spiritual clarity, and make these judgments correspond to metal, wood, water, fire, and earth, as well as the four seasons, eight winds, and six directions, without deviating from the constant Dao—this is what is meant here. “Gong” here refers to one skilled in nurturing life and the medical Dao; only one who understands these principles may practice medicine in the world.

The New Revision adds: Wang Bing’s commentary on “times are established and Qi is distributed” says that before spring begins, when the season is about to arrive, the pulse Qi of the governing period will also appear. According to the meaning here, it says that a year establishes the four seasons, the four seasons distribute the six Qi, and they cycle without end, so it also says that the changes of “hou” follow the same pattern.

The Yellow Emperor asked: If the workings of the Five Movements are like a ring without end, then what about their excess and deficiency?

Qibo answered: The Qi of the Five Phases take turns governing; each has what it overcomes; there is flourishing and decline, and these changes are all normal patterns.

That is to say, the occurrence of flourishing and decline is originally the constant condition of the Heavenly Dao.

The Yellow Emperor asked, "What is balanced qi (pingqi, qi that moves evenly, without excess or deficiency)?" Qi Bo answered, "Without deviation, that is balanced qi. Without going against the normal changes of the seasons, there is no fault."

The Yellow Emperor asked, "What do excess (taiguo) and deficiency (buji) mean?" Qi Bo answered, "The classics explain this."

This passage refers to the chapter "Yuji Zhenzang Lun" (Treatise on the True Viscera According to the Jade Pivot), which discusses in detail the meaning of balanced qi in the Five Phases and of excess and deficiency.

A note by the collators adds that Wang Bing's commentary states that the "Yuji Zhenzang Lun" has already explained this. On close reading, however, that chapter treats excess and deficiency in the pulse, and does not discuss the excess, deficiency, and balance of yunqi (cyclical qi patterns). The passage should instead refer to the "Qijiao Biandalun" (Great Treatise on the Changing Qi Exchanges) and the "Wuchangzheng Dalun" (Great Treatise on the Five Constant Governances). Those two chapters already treat the matter in full.

The Yellow Emperor asked, "What is mutual overcoming (xiangsheng, the restraint among the Five Phases)?" Qi Bo answered, "Spring overcomes Late Summer (changxia), Late Summer overcomes Winter, Winter overcomes Summer, Summer overcomes Autumn, and Autumn overcomes Spring. This is the pattern in which the Five Phases restrain one another according to the seasons. The qi of each season corresponds to and is named for one zang (organ)."

Spring corresponds to Wood, and Wood overcomes Earth, so Spring overcomes Late Summer. Late Summer corresponds to Earth, and Earth overcomes Water, so Late Summer overcomes Winter. Winter corresponds to Water, and Water overcomes Fire, so Winter overcomes Summer. Summer corresponds to Fire, and Fire overcomes Metal, so Summer overcomes Autumn. Autumn corresponds to Metal, and Metal overcomes Wood, so Autumn overcomes Spring. Adding Late Summer to the four seasons gives the five-phase pattern of seasonal overcoming described here.

Late Summer refers to the sixth lunar month. Earth is generated by Fire and flourishes in the middle of summer, and it reaches its peak in Late Summer, which is why the season is so named. "Naming the zang by the qi" means assigning organs to seasonal qi: Spring belongs to Wood and corresponds to the Liver; Late Summer belongs to Earth and corresponds to the Spleen; Winter belongs to Water and corresponds to the Kidneys; Summer belongs to Fire and corresponds to the Heart; and Autumn belongs to Metal and corresponds to the Lungs. "Ming" here means to name or to designate.

The Yellow Emperor asked, "How can one know this pattern of overcoming?" Qi Bo answered, "One must observe the moment when each qi arrives. These seasonal qi all begin at Lichun (the beginning of Spring)."

"Shichun" (the start of Spring) refers to the day of Lichun. Spring is the beginning of the year, so observing the seasonal qi starts from the days around Lichun.

"Arriving before its time" (weizhi er zhi) means that a qi arrives early, before the moment when it should come. This is called excess. It suppresses the qi it cannot normally control, and it takes advantage of the situation to restrain the qi it normally controls. This is called "qi yin" (excessive, unruly qi), in which evil qi easily grows within the body, and even skilled physicians find it difficult to stop.

According to the collators, the ten characters following "arriving before its time" do not make sense as written. They may be a textual displacement in the ancient text, and they originally belonged after the passage on the "five governances" (wuzhi) below. Here they are provisionally marked with a vermilion brush.

"Failing to arrive when due" (zhi er bu zhi) means that a qi does not arrive at the time it should. This is called deficiency. The qi it restrains then moves abnormally; the qi it generates suffers harm; and the qi that restrains it presses in to take advantage. This is called "qi po" (qi compulsion). The phrase "observing when the qi arrives" means observing the seasons when each qi ought to arrive.

The arrival times of each qi are all counted from fifteen days before Lichun…

"Qi that should have arrived but comes early" is called excess (tàiguò). Early arrival shows that the qi's force is in surplus. When qi that should arrive at its proper time fails to come, or comes late, this is called deficiency (bùjí), which shows that its force is insufficient.

In excess, overabundant qi presses upon the phase it cannot restrain and, taking advantage of its momentum, invades the phase it can restrain. In deficiency, the phase it ordinarily restrains loses its check and runs unchecked, and the phase it generates is also affected by illness.

Within the relations of the Five Phases (wǔxíng), the phase I restrain is called "what I overcome" (suǒshèng), the phase that restrains me is called "what overcomes me" (suǒ bù shèng), and the phase I generate is called "what I generate" (suǒshēng). For example, the liver belongs to Wood. If liver Wood is in excess while lung Metal is deficient, Metal cannot restrain Wood, and Wood qi becomes excessive. This overabundant Wood qi then presses upon lung Metal and, taking advantage of this, invades spleen Earth. Hence the text says that excessive qi presses upon "what overcomes me" and invades "what I overcome." This is the mutual disturbance and combination of the qi of the five viscera (wǔzàng) within the body, which causes illness. It is called qìyín (qi excess), meaning that qi-movement has become so strong that it disturbs the other organs. Other cases of excess follow the same pattern.

Consider next the case of deficiency. If liver Wood qi is insufficient and cannot restrain spleen Earth, Earth qi loses its check and runs wild. Wood, bullied by Earth, is therefore described as "what I overcome runs wild" (suǒshèng wàngxíng), and the organs that Wood generates also fall ill. When liver Wood is disordered, lung Metal qi takes the opportunity to press upon it, which is why the text says that "what overcomes me presses upon it," meaning that the force that restrains it comes pressing in. When Wood qi is disordered and Earth and Metal qi press upon each other in turn, illness results. This is called qìpò (qi oppression), meaning that the qi-movements press upon one another. Other cases of deficiency are the same.

One must carefully observe the seasons when qi-movements arrive before one can infer their changes. If one misses the proper timing and instead judges by going against the seasons, and cannot distinguish the governance of each of the Five Phases, then pathogenic qi will arise within the body, and physicians will be unable to prevent or treat it.

Here, "timing" refers to the seasons when qi-movements arrive. The qi of the year is observed beginning at the Beginning of Spring (lìchūn). The qi of the four seasons is observed according to the fixed sequence of the four qi (the seasonal qi-movements). The qi of particular days is determined according to the corresponding climatic periods (hòu). Therefore the text says that one must carefully observe the seasonal qi in order to infer from it. "Against" (fǎn) here means to go contrary to. "Five governances" (wǔzhì) refers to each of the Five Phases presiding over and governing the qi-movements of the year in turn. If one cannot distinguish the governance of each phase, one's judgment will err and pathogenic qi will enter through the gaps. If one has not fully grasped the normal qi-movements and patterns of change of heaven and earth, how could one precisely understand the causes of human illness? Hence the text says that physicians cannot prevent or treat it.

The Yellow Emperor (Huángdì) asked: "Is there any case in which the qi of the Five Phases does not succeed one another in order?"

Qi Bo (Qí Bó) replied: "The qi moving through the azure heavens never lacks regularity. When qi-movements do not follow their regular succession, this is called 'irregularity' (fēicháng), and when irregularity occurs, change follows."

Here, "change" refers to the alteration that occurs when the movements of heaven and earth depart from their regular course.

The Yellow Emperor asked, "What kinds of conditions arise from unusual changes in climate?"

Qi Bo replied, "Once climatic change occurs, people may fall ill. If the change strikes the organs that the affected phase controls, the illness is milder. If it strikes the organs that control that phase, the illness is more severe. If, on top of this, one is repeatedly attacked by pathogenic influences, death may follow. Therefore, when the climate changes outside its governing season, the illness is milder, and when the change coincides with its governing season, the illness is more severe."

This passage shows that Heaven, in revolving and dispensing its climates, still does not step outside the regularities of the Five Phases (Wuxing). Since people live within the Qi of Heaven and Earth, how could they fail to respond to the Dao of Heaven? When a person's Qi is disordered and fails to accord with the constant way of nature, signs of illness and even death appear. The Zuo Zhuan says, "To act against the Dao of Heaven is inauspicious." This is precisely the kind of situation it describes.

For example, suppose that in a given year Wood Qi is in governance, and then Fire Qi comes to exert its influence. Illness may then arise two years later. If Earth Qi comes to exert its influence, illness may arise three years later. If Metal Qi does so, illness may arise four years later. If Water Qi does so, illness may arise five years later. If a person's true Qi is insufficient and is repeatedly attacked by pathogenic influences, the true Qi will wither within the body, and death may result.

When it is not the governing year of a given Qi, and different Qi merely influence one another, the usual result is only a mild illness. Such an illness does not necessarily harm the spirit or the organs, so it is mild and easier to keep under control. When the year coincides with the governing Qi, a person is more easily invaded by pathogenic influences, and the illness progresses more severely. Every governing Qi tends to make people susceptible to pathogens. Hence it is said, "Outside its governing season, the illness is mild; within its governing season, the illness is severe."

The Discussion on Vacuity and Repletion (Tong Ping Xu Shi Lun) says, "Outside its governing season, one can survive; within its governing season, one will die." Here, "governing season" refers to the year in which a particular Qi is in charge.

The Yellow Emperor said, "Well said. I have heard that when Qi come together, they form tangible things, and that by following their transformations one can distinguish their names. When Heaven and Earth revolve and Yin and Yang transform, among the myriad things, which kinds are abundant and which are scarce? Could you tell me?"

The Xin Jiao Zheng (Newly Collated Edition) notes: On close reading of the preceding text, the passage from Qi Bo's remark "Well asked" down to this point does not appear in the Quan Yuanqi commentary edition or in the Tai Su. It appears to have been added by Wang Bing.

Qi Bo said, "This question is very comprehensive. Heaven is vast beyond measure; Earth is broad beyond calculation. Since you have raised the question with a grand intention, allow me to set out its essentials.

"Plants and trees grow and display five colors, and the variations of color are too many to see completely. Plants and trees grow and possess five flavors, and the subtleties of taste are too many to taste completely."

The meaning here is this: the myriad things are numerous, and each receives its own particular transformation, which produces differences. Relying on the eyes to look and the mouth to taste, people still cannot exhaust their variety.

People's hearts can hold so much that no account could list every situation one by one. Tastes and desires differ, so each person has their own preferences. The colors, scents, and flavors of the world are too many to name, yet what each person likes and wants is still largely decided by their own inclinations. This is why tastes and desires differ and each has its own preferences.

Heaven nourishes people with five kinds of breath (qi), and Earth nourishes them with five kinds of flavor. The five breaths that Heaven uses are: the rank odor belongs to the liver, the scorched odor to the heart, the fragrant odor to the spleen, the fishy odor to the lungs, and the putrid odor to the kidneys. The five flavors that Earth uses are: sourness enters the liver, bitterness enters the heart, sweetness enters the spleen, pungency enters the lungs, and saltiness enters the kidneys.

The clear yang qi transforms into breath and rises upward, like Heaven. The turbid yin substance condenses into flavor and sinks downward, like Earth. Thus it is said that Heaven nourishes people through qi and Earth nourishes them through flavor. The Great Treatise on Yin-Yang and the Correspondence to Phenomena (Yinyang Yingxiang Dalun) says, "Clear yang is Heaven, turbid yin is Earth," and again, "Yang is qi, yin is flavor."

The five breaths enter through the nose and are stored in the heart and lungs, which keeps the complexion lustrous and bright and the voice clear and resonant. The five flavors enter through the mouth and are stored in the stomach and intestines, where their nutrients nourish the five breaths. When the five breaths are in harmony, bodily fluids (such as saliva) are produced. When these fluids and qi work together, spirit-qi (shenqi) arises naturally.

The heart corresponds to the complexion and the lungs govern the voice, so when qi is stored in the heart and lungs, it can make the complexion glossy and clear and the voice distinct and bright. Qi is the basis for the production of fluids, so when the five flavors are stored in the stomach and intestines, they can nourish the five breaths, and only when the breaths are in harmony can fluids be generated. Fluids and qi together transform into spirit-qi, from which spirit (shen) is produced and begins to function.

The Yellow Emperor (Huangdi) asked, "What are the manifestations of the zang organs?"

What is called "manifestation" refers to the signs that can be observed from outside the body.

Qi Bo replied, "The heart is the root of life and the master of spirit illumination (shenming). Its glory shows in the face and it nourishes the blood vessels. It belongs to the greatest yang within yang and corresponds to the qi of summer."

The heart is the ruler's official, from which spirit illumination emerges. The ruler governs the rise and fall of all things, so the heart is called the root of life and the master of spirit's transformations. Fire qi rises, so the heart's glory appears in the face. The heart nourishes the blood and governs the vessels, so its nourishment manifests in the blood vessels. The heart flourishes in summer and corresponds to the sun's yang qi. Since the sun's qi resides within the fire qi of summer, the heart is called "the greatest yang within yang" and is said to correspond to summer qi.

The Jin Gui Zhen Yan Lun (Discourse on the Essential Truths of the Golden Cabinet) says, "From dawn to noon is the yang within the yang of Heaven..."

Among the five zang organs, the lung belongs to the yin within the yang position and governs the qi of autumn. The lung is the root of the body's qi (Qi) and the dwelling place of the po (corporeal soul). Lung qi nourishes the skin and body hair, so the lung's glory appears in the body hair, and its nourishing function is seen in the skin. The lung belongs to the qi of Taiyin (Greater Yin) and corresponds to autumn. Autumn daylight still lies within the yang portion, so the classic calls the lung "taiyin within yang" (yang zhong zhi taiyin), linking it to autumn qi. The Jin Kui Zhen Yan Lun (Treatise on True Words from the Golden Cabinet) states that the period from midday to dusk is the yin within the yang of Heaven.

[Xin Jiao Zheng, the New Collation, holds that "Taiyin" should read "Shaoyin." Although the lung belongs to the Taiyin channel among the twelve channels, it lies within the yang portion, so here it should be called "Shaoyin."]

The kidney governs closing and storing, as all things go into hiding and gates are shut in winter. It also stores the jing (essence) and qi of the five zang and six fu organs, so the kidney is called the root of sealed storage and the dwelling place of essential qi. The brain is where the sui (marrow) converges. The kidney governs the bones and is related to bone marrow, and since the hair is nourished by brain marrow, the kidney's glory appears in the hair, and its nourishing function is seen in the bones. The kidney flourishes in the yin portion of winter, so the classic calls it "shaoyin within yin" (yin zhong zhi shaoyin), linking it to winter qi. The Jin Kui Zhen Yan Lun states that the period from night to cockcrow is the yin within the yin of Heaven.

[Xin Jiao Zheng holds that "Shaoyin" should read "Taiyin." Although the kidney belongs to the Shaoyin channel among the twelve channels, it lies within the yin portion, so here it should be called "Taiyin."]

The liver is the root of the body's endurance under fatigue and the dwelling place of the hun (ethereal soul). The liver's glory appears in the nails, and its nourishing function is seen in the sinews. The liver is also involved in the production of blood and qi (xueqi). The text next records that the liver's flavor is sour and its color is greenish-blue.

[Xin Jiao Zheng holds that the six-character phrase "its flavor is sour, its color is greenish-blue" should be deleted. According to the Tai Su (Plain Questions Compendium), the heart, lung, and kidney also list flavors and colors, and the Yin Yang Ying Xiang Da Lun (Great Treatise on Yin-Yang Correspondences) has already explained in detail the colors and flavors corresponding to the five zang, so there is no need to repeat them here.]

The liver belongs to the Lesser Yang (shaoyang) within Yang, the category of yang qi that is more recently born and weaker, and it corresponds with the qi of spring.

All human activity depends on the strength of the sinews (jin), and the liver governs the sinews. The spirit stored in the liver is the ethereal soul (hun). The liver is therefore the foundation of the body's capacity to endure fatigue and the place where the hun resides. The nails are the terminal extension of the sinews, and the sinews are nourished by liver qi, so the liver's vitality appears in the nails and its fullness appears in the sinews.

The east is the direction where all things begin to sprout, so the liver can generate blood and qi. The Lesser Yang lies in the yang position and is at its height in spring, which is why it is described as "Lesser Yang within Yang, corresponding to the qi of spring." The Jinkui Zhenyan Lun (Treatise on the Essential Truths of the Golden Chamber) states: "From dawn to midday is the yang qi of Heaven; within yang, it is yang again."

The Xinjiaozheng (Newly Collated Edition) notes that the Quanyuanqi edition, the Jiayi Jing (Classic of Acupuncture and Moxibustion), and the Taisu (Plain Questions) all read "Lesser Yang within Yin" at this point, and that this reading should be adopted. Wang Bing cites the Jinkui Zhenyan Lun passage "From dawn to midday is the yang of Heaven, and within yang it is yang" to support "Lesser Yang within Yang," which shows that he took the text to read that way. However, when he earlier described the heart as "Greater Yang within Yang," he cited the same dawn-to-midday passage as support. In explaining the liver, he again relied on that passage but did not cite the complementary line, "From cockcrow to dawn is the yin qi of Heaven; within yin, it is yang." Wang Bing's commentary is therefore in error here, and the reading "Lesser Yang within Yin" in the Quanyuanqi edition, the Jiayi Jing, and the Taisu should be followed.

The spleen, stomach, large intestine, small intestine, Sanjiao (Triple Burner), and bladder are the foundation for storing and transporting food and drink (shuigu), and they are the place where ying qi (the nourishing qi that sustains the body) resides. They are called "vessels" (qi) because they digest the dregs of food, transform the flavors of what is eaten, and move these substances in and out. All of these organs can receive, hold, and continually transport material, which is why they are the foundation of storage and transport. Ying qi arises in the Zhongjiao (Middle Burner), the region where the spleen and stomach are located, which is why it is said to reside there. Once the flavors of food and drink enter the spleen and stomach, these organs digest and transform them. The dregs and the transformed essence are then sent out through the Triple Burner and the bladder, which is why these organs are said to be able to transform flavors...

The spleen governs the flesh and muscles, so its glory is said to appear in the white skin around the lips and to be nourished within the muscles. The flavor corresponding to the spleen is sweet, and its color is yellow. These six characters, along with the forty characters from the Yin-Yang Ying Xiang Da Lun quoted in the commentary, should all be deleted according to the Xin Jiao Zheng (New Collation); the relevant content has already been explained earlier in the text.

The spleen belongs to the "Supreme Yin" (zhi yin) and is connected to the qi of Earth (tu qi). The mouth is the orifice governed by the spleen, and the spleen also governs the flesh and muscles, which is why its glory is said to appear around the lips and to be nourished in the muscle. "The four whites of the lips" (chun si bai) refers to the white skin and flesh surrounding the lips. The Yin-Yang Ying Xiang Da Lun states that the center generates dampness, dampness generates Earth, and Earth generates sweetness; since the spleen is paired with Earth, its flavor is sweet. The same text also associates the spleen with the viscera-stored element and with yellow, which is why the spleen's color is yellow. The spleen stores the qi of Earth and corresponds to the Supreme Yin, so it is said to belong to the Supreme Yin and to be connected with the qi of Earth. The Jin Gui Zhen Yan Lun says that the most yin within yin is the spleen.

All eleven viscera depend on the gallbladder.

Counting downward from the heart to the gallbladder, there are eleven viscera. The gallbladder occupies a central, upright position, is resolute and decisive, and shows no partiality or bias. For this reason, it is said that the functions of all eleven viscera depend on the gallbladder.

If the Renying pulse (the pulse at the neck) is one times stronger than the Cunkou pulse (the pulse at the wrist), the disease lies in the Lesser Yang; if it is two times stronger, the disease lies in the Greater Yang; if it is three times stronger, the disease lies in the Yangming; and if it is four times stronger or more, it is called "Ge Yang" (yang rejection).

This is the method of diagnosing by the yang pulses. The Lesser Yang corresponds to the gallbladder channel, the Greater Yang to the bladder channel, and the Yangming to the stomach channel. The Lingshu Jing states: if the pulse is one times stronger and agitated, the disease lies in the Hand Lesser Yang; two times stronger and agitated, in the Hand Greater Yang; three times stronger and agitated, in the Hand Yangming. The Hand Lesser Yang, Hand Greater Yang, and Hand Yangming correspond respectively to the Triple Burner, small intestine, and large intestine channels. By "one times stronger," it is meant that the Renying pulse is twice the size of the Cunkou pulse; the other multiples follow by analogy. When the strength exceeds four times, yang qi is at its extreme and rejects yin qi, so that food cannot be swallowed. The Zheng Li Lun says: "Ge" (rejection) causes vomiting.

If the Cunkou pulse is one times stronger than the Renying pulse, the disease lies in the Jueyin; if it is two times stronger, the disease lies in the Shaoyin; if it is three times stronger, the disease lies in the Taiyin; and if it is four times stronger or more, it is called "Guan Yin" (yin barrier).

This is the method of diagnosing by the yin pulses. The Jueyin corresponds to the liver channel, the Shaoyin to the kidney channel, and the Taiyin to the spleen channel. The Lingshu Jing states: if the pulse is one times stronger and agitated, the disease lies in the Hand Jueyin; two times stronger and agitated, in the Hand Shaoyin; three times stronger and agitated, in the Hand Taiyin. The Hand Jueyin, Hand Shaoyin, and Hand Taiyin correspond respectively to the pericardium, heart, and lung channels.

The pulse is surging. Following the principle stated earlier, when the yang pulse reaches more than four times its normal strength, yin qi has become excessive to the extreme. The guan (barrier) pulse is therefore blocked, and urine cannot flow freely. The Zhenglun (Correct Discourse) says: "When the guan is blocked and obstructed, urination cannot occur." Here, sou refers to urine.

When both the renying (human welcoming) pulse and the cunkou (inch-opening) pulse, the pulse positions used to examine the qi, blood, and yin-yang of the body, are more than four times stronger than normal, this is called guange (barrier and reversal). When the guange pulse reaches its extreme, the body can no longer fully receive the jing qi (essential qi) of heaven and earth, and death follows. The phrase "both pulses abundant" means that each is four times stronger than normal. Nothing can remain at its extreme for long. Once it reaches its peak, it declines. Therefore a person cannot continually receive the jing qi of heaven and earth and will eventually die. The Lingshu Jing (Spiritual Pivot) says: "When yin and yang both flourish and cannot coordinate their circulation with each other, this is called guange. A person with guange cannot live out the full span of life allotted to them and will die." This passage describes exactly this condition.

The Xin Jiaozheng (New Collation) holds that the word léi (weak) should be read as yíng (full). A pulse that is four times stronger than normal cannot be called weak, but rather has reached an excess. In ancient texts, léi and yíng were often used interchangeably.