《黃帝素問靈樞集註》Vol. 18

Huang Di inquired of Shao Yu (an ancient physician): "When food enters the mouth, how do different flavors affect specific parts of the body? Sourness primarily influences the sinews, and excessive consumption can cause difficulty in urination. Saltiness affects the blood, and overindulgence leads to thirst. Pungency impacts the Qi (vital energy) mechanism, and too much creates heartburn. Bitterness affects the bones, and excessive intake easily induces vomiting. Sweetness influences the muscles, and immoderate consumption brings about mental restlessness."

Shao Yu explained in detail: "When sour flavors enter the stomach, their astringent nature slows the movement of Qi. If it cannot properly circulate to the upper and middle Jiao (the upper abdominal regions), it stagnates in the stomach. In the stomach's warm environment, the sourness descends to the bladder, causing its walls to contract and resulting in difficult urination. Since the sinews converge in the yin regions, sour flavors ultimately affect the sinew system."

"Saltiness entering the body causes Qi and blood to concentrate in the blood vessels. When salt meets blood, it thickens it, requiring the stomach to secrete more fluids for dilution, leading to throat dryness and thirst. As blood vessels are the pathways of the middle Jiao (the body's central region), saltiness primarily acts upon the blood system."

"Pungent foods direct their Qi upward to the upper Jiao (chest region), stimulating the movement of Yang Qi. But when they linger below the heart (above the stomach) for too long, they create a burning sensation. The pungent Qi is eventually expelled from the body through sweat."

"Bitterness entering the stomach inhibits the digestion of grains, causing obstruction in the three Jiao (the body's three major energy pathways) and inducing vomiting. Since teeth are extensions of the stomach, bitterness ultimately affects the skeletal system - hence vomiting reveals its action upon the bones."

"When sweetness enters the stomach, due to its gentle nature..."

This scripture primarily discusses the classification of human constitutions in Traditional Chinese Medicine theory, recording a dialogue between the Yellow Emperor and his physicians Qibo and Bogao about discerning internal Qi-blood conditions through external observations.

The Yellow Emperor inquired how to distinguish people with Yin-Yang constitutions. Bogao replied that all things between heaven and earth follow the patterns of the Five Phases (Wood, Fire, Earth, Metal, Water), and humans correspond to these phases, resulting in twenty-five constitutional types. However, those with Yin-Yang constitutions don't belong among these twenty-five types, as their characteristics differ from ordinary people.

Qibo supplemented that this was secret knowledge transmitted by ancient masters. One must first identify the five basic constitutional types (Metal, Wood, Water, Fire, Earth), then further differentiate them according to the five colors (green, red, yellow, white, black) and physical characteristics to master the method of discerning the twenty-five types. The Yellow Emperor respectfully requested detailed explanations.

The text elaborates on the characteristics of Wood-type and Fire-type constitutions:

Wood-type individuals resemble spring's vitality, with slightly greenish skin, small heads and long faces, broad shoulders and backs, slender builds, and relatively small hands and feet. These intelligent people tend toward fatigue and melancholy, thriving in spring and summer while being prone to illness in autumn and winter. They further divide into five subtypes corresponding to different meridian characteristics.

Fire-type individuals embody summer's passion, with reddish skin, small faces and heads, well-developed shoulder, back and abdominal muscles, and nimble hands and feet. These agile, extroverted individuals place little importance on material wealth. They similarly divide into several subtypes.

This passage exemplifies TCM's diagnostic principle of "knowing the interior through the exterior," using physical appearance to determine constitutional types and disease predispositions, laying the foundation for later TCM constitutional theory. The mentioned Five Phases classification and meridian correspondences remain vital concepts in TCM theory.

This passage explains how ancient Chinese medicine categorized human constitutions into five types based on the Five Phases (Wood, Fire, Earth, Metal, Water) theory, with each type having subcategories and indicating seasonal disease susceptibilities. Here's the modern interpretation:

People belonging to the Fire phase (called "Zhi Zhi persons") are characterized by talkativeness, overthinking, keen observation, reddish complexion, and impatience. They generally have shorter lifespans and are prone to sudden illnesses. While they adapt well to spring and summer, autumn and winter make them susceptible to diseases, manifesting abnormalities in the Heart Meridian of Hand-Shaoyin when illness strikes. Subtypes include: those with well-developed muscles like the Small Intestine Meridian of Hand-Taiyang; restless types resembling the right-side Small Intestine Meridian; and others displaying shark-like alertness or bear-like steadiness.

Earth-phase individuals ("Tu Xing persons") exhibit yellow skin, round faces, large heads, full shoulders/backs, thick abdomens/thighs, and small fleshy hands/feet with overall proportionality. They walk steadily, demonstrate pragmatic personalities, lack ambition for power, and enjoy social connections. These people thrive in autumn/winter but fall ill easily in spring/summer, experiencing heaviness in the Spleen Meridian of Foot-Taiyang when sick. Subtypes range from docile types resembling the Stomach Meridian of Left Foot-Yangming to more restless varieties.

Metal-phase persons ("Jin Xing persons") have square faces, pale skin, small heads/narrow shoulders, prominent hand/foot bones, and nimble movements. With upright, resolute personalities suited for official positions, they adapt to autumn/winter but fear spring/summer, showing abnormalities in the Lung Meridian of Hand-Taiyin when ill. Subtypes include square-built types like the Large Intestine Meridian of Left Hand-Yangming and looser varieties.

Water-phase individuals ("Shui Xing persons") display dark skin, irregular facial features, large heads with pointed chins, resembling characteristics of the Black Emperor of the North.

This system connects constitution, personality, disease susceptibility, and corresponding meridians through Five Phases classification—a crucial component of ancient Chinese medical constitutional theory. Each constitution shows varying seasonal adaptability, with specific meridian symptoms manifesting during illness.

This scripture primarily discusses the relationship between human physical characteristics and the waxing-waning of Qi-blood (Qi), as well as the susceptibility to seasonal illnesses among different constitutional types. The text mentions that five basic constitutional types (the Five-Phase persons) give rise to twenty-five variations, and these differences may lead to mutual misunderstandings among people.

The Yellow Emperor (Huangdi) asked Qibo: What happens when a person's physical appearance doesn't match their facial complexion? Qibo replied: When physical characteristics dominate facial complexion, or when complexion dominates physical form, encountering conflicting annual cycles may lead to illness; if form and color harmonize, it indicates prosperity and good health. Qibo particularly emphasized several critical ages in human life (7, 16, 25, 34, 43, 52, and 61 years) requiring special attention, as these years are prone to illness or misfortune, demanding cautious conduct.

The latter section details the manifestations of Qi-blood abundance or deficiency in the Foot Yangming (Stomach) and Foot Shaoyang (Gallbladder) meridians. For example:

• Those with abundant Qi-blood in the Foot Yangming meridian have long, thick beards on the chin; deficiency manifests as sparse or absent facial hair with many wrinkles around the mouth.
• When the lower portion of the Foot Yangming meridian has abundant Qi-blood, chest and abdominal hair grows thickly; imbalance shows as short body hair, weak foot muscles, and susceptibility to cold or frostbite.
• Individuals with strong Qi-blood in the Foot Shaoyang meridian grow thick sideburns; deficiency results in sparse facial hair and vulnerability to joint pain with brittle nails when exposed to cold-damp conditions.

These observations reflect ancient Chinese medical diagnostic methods that assess internal Qi-blood conditions through external features, emphasizing the holistic view of form-Qi correspondence. The concept of "yearly prohibitions" (Nianji) mentioned in the text demonstrates traditional medicine's emphasis on life rhythms and disease prevention.

This scripture explains how to assess the abundance or deficiency of Qi and blood within the body by observing external features such as hair, muscles, and skin in different body regions, and how to apply acupuncture accordingly.

For those with abundant Qi and blood in the Gallbladder Meridian of Foot-Shaoyang (lower limb section), the calf hair is dense and long, and the outer ankle is plump. Those with more blood but less Qi have dense but shorter calf hair, with thick and firm skin on the outer ankle. Those with less blood but more Qi have sparse calf hair and thin, withered skin on the outer ankle. If both Qi and blood are deficient, the calf is hairless, and the outer ankle is emaciated with no flesh.

For those with abundant Qi and blood in the Bladder Meridian of Foot-Taiyang (facial section), the eyebrows are elegant, and there are fine, long hairs between them. Those with more blood but less Qi have sparse eyebrows and many facial wrinkles. Those with less blood but more Qi have plump facial muscles. When Qi and blood are harmonized, the complexion is rosy and attractive.

For those with abundant Qi and blood in the Spleen Meridian of Foot-Taiyin (heel section), the heel muscles are full and firm. Those with less Qi but more blood have thin, sunken heels. If both Qi and blood are deficient, cramps are common, and there is pain beneath the heel.

For those with abundant Qi and blood in the Large Intestine Meridian of Hand-Yangming (facial section), the beard is handsome. Those with less blood but more Qi have unkempt beards, while those deficient in both Qi and blood grow no beard. (Underarm section) Those with abundant Qi and blood have dense underarm hair and warm, fleshy thenar eminences. Those deficient in Qi and blood have thin, cold palms.

For those with abundant Qi and blood in the Triple Burner Meridian of Hand-Shaoyang (facial section), the eyebrows are long and elegant, and the ears have a healthy color. Those deficient in Qi and blood have dry, dull-colored ears. (Hand section) Those with abundant Qi and blood have thick, warm palms, while those deficient in Qi and blood have thin, cold palms. Those with less Qi but more blood have thin palms with prominent veins.

For those with abundant Qi and blood in the Small Intestine Meridian of Hand-Taiyang (facial section), the beard is thick, and the facial muscles are well-proportioned. Those deficient in Qi and blood have thin faces with poor complexion. (Palm section) Those with abundant Qi and blood have plump palms, while those deficient in Qi and blood have thin, cold palms.

The Yellow Emperor asked: "What are the principles for acupuncture treatment for these twenty-five constitutional types?" Qi Bo replied: "Elegant eyebrows indicate abundant Qi and blood in the Foot-Taiyang meridian, while sparse eyebrows indicate deficiency. A plump body with moist skin signifies excess Qi and blood; plumpness with dry skin indicates excess Qi but insufficient blood; emaciation with dull skin means both Qi and blood are deficient. By observing physical characteristics and the state of Qi and blood, one can grasp the principles of treatment."

The Yellow Emperor further asked: "How should the Yin and Yang meridians be regulated with acupuncture?" Qi Bo answered: "First, diagnose the Cunkou and Renying pulses to harmonize Yin and Yang. Then, palpate along the meridians to detect stagnation or blockages of Qi and blood, which often manifest as pain, numbness, or even restricted movement in severe cases. For areas of Qi and blood stagnation, apply warming and tonifying techniques to promote circulation, stopping once harmony is restored. For meridian blockages, use bloodletting therapy to unblock the vessels until smooth flow is achieved."

This passage discusses the principles and methods of acupuncture treatment in Traditional Chinese Medicine. When a patient's Qi (vital energy) is excessively abundant in the upper body, guiding techniques should be used to direct the energy downward; when there's deficiency of Qi in the upper body, massage techniques should be applied to restore blood and Qi circulation. For cases where Qi and blood flow is stagnant or blocked, the complementary techniques of reinforcing and reducing should be employed to regulate the flow.

The practitioner must thoroughly understand the pathways of the meridians (the body's energy channels) to administer proper treatment. For conditions involving conflict between cold and heat, guiding techniques should be used to facilitate smooth Qi and blood circulation. When detecting stagnant blood that hasn't yet formed clots in the body, timely dredging treatment should be administered.

Before performing acupuncture, the physician must first master the twenty-five constitutional types (an ancient classification system categorizing people into twenty-five types according to the Five Phases [Wood, Fire, Earth, Metal, Water]). Only then can they accurately assess the distribution of Qi and blood in the patient's left-right and upper-lower body regions, thereby achieving precise needle treatment.

The final rare characters are ancient medical terms: "Dai" (pronounced like "da") refers to metal needles; "Tadaoqie" describes needle sensation; "Jiao" indicates certain special needling techniques; "Hang" denotes the lower leg area; and "Zhiyuqie" refers to frostbite-like conditions. These terms reflect the specialized terminology system of ancient acupuncture.