《黃帝素問靈樞集註》Vol. 19

This scripture primarily discusses the correspondences between the ancient Chinese five musical tones (Gong, Shang, Jue, Zhi, Yu) and various aspects of human physiology including meridians, organs, seasons, and foods. Here's a modern interpretation of its main content:

Different musical tones correspond to specific meridian locations in the human body. For instance, the Right Zhi and Lesser Zhi tones correspond to the upper section of the Taiyang meridian on the right hand, while the Left Shang and Left Zhi tones correspond to the upper section of the Yangming meridian on the left hand. Each musical tone also corresponds to particular grains, livestock, fruits, organs, colors, flavors, and seasons. For example:

The Upper Zhi and Right Zhi tones correspond to eating wheat, raising sheep, and consuming apricots. They relate to the Hand Shaoyang meridian connecting to the heart, represented by the color red, the bitter flavor, and corresponding to summer.

The Upper Yu and Great Yu tones correspond to eating soybeans, raising pigs, and consuming chestnuts. They connect to the Foot Shaoyin meridian associated with the kidneys, represented by black, the salty flavor, and corresponding to winter.

The Upper Gong and Great Gong tones correspond to eating millet, raising cattle, and consuming dates. They connect to the Foot Taiyin meridian associated with the spleen, represented by yellow, the sweet flavor, and corresponding to late summer.

The Upper Shang and Right Shang tones correspond to eating glutinous millet, raising chickens, and consuming peaches. They connect to the Hand Taiyin meridian associated with the lungs, represented by white, the pungent flavor, and corresponding to autumn.

The Upper Jue and Great Jue tones correspond to eating hemp seeds, raising dogs, and consuming plums. They connect to the Foot Jueyin meridian associated with the liver, represented by green/blue, the sour flavor, and corresponding to spring.

These correspondences embody the holistic concept of "cosmic-human resonance" in ancient Chinese medicine, which interconnects music, diet, seasonal changes, and human health. The specific meridian positions corresponding to different musical tones might have been used to guide music therapy or acupuncture treatment positioning.

The Yellow Emperor asked Qibo: "Do women not grow beards because they lack sufficient qi and blood?" Qibo replied: "The Chong and Ren meridians (important channels in the human body) both originate from the uterus, ascending along the inner back to form a sea where all channels converge. Their superficial branches run up the right side of the abdomen, meeting at the throat before dividing to encircle the lips. When qi and blood are vigorous, they nourish the skin and warm the muscles; when blood is particularly abundant, it permeates the skin to grow body hair. But women are naturally endowed with surplus qi and deficient blood due to their monthly menstrual discharge. The qi-blood of the Chong and Ren meridians cannot fully nourish their lips, hence they don't grow beards."

The Emperor further inquired: "Some men suffer genital injuries that impair sexual function yet retain their beards, while eunuchs lose theirs—why is this?" Qibo explained: "Eunuchs have their testicles (ancestral sinews) removed, damaging the Chong meridian. After blood loss they cannot recover, causing qi-blood stagnation in the skin so lips receive no nourishment—thus no beard grows." The Emperor continued: "What of naturally beardless men (congenital eunuchs) who've suffered neither injury nor blood loss?" Qibo said: "This stems from innate deficiency—their Ren and Chong meridians lack vigor, reproductive organs remain underdeveloped with qi but no blood, leaving lips unnourished and beardless." The Emperor marveled: "The sage's understanding of all creation is truly comprehensive!"

The discourse then turns to observing qi-blood through external signs: those with yellow-red complexions tend toward heat qi, blue-white complexions show less heat qi, while dark-skinned individuals typically have abundant blood but scarce qi. Thick eyebrows indicate vigorous qi-blood in the Taiyang meridian; full sideburns show strong Shaoyang meridian qi-blood; handsome beards reflect robust qi-blood in the Yangming meridian. These are fundamental patterns: Taiyang usually has abundant blood but scarce qi; Shaoyang abundant qi but scarce blood; Yangming has both qi and blood vigorous; Jueyin abundant qi but scarce blood; Shaoyin abundant blood but scarce qi; Taiyin abundant blood but scarce qi—all determined by innate constitutional endowment.

In the chapter "On the Origins of All Diseases," the Yellow Emperor consulted Qibo: "All illnesses arise from external pathogens like wind, rain, cold, and summerheat, as well as emotional excess. Emotional turmoil damages the internal organs, wind-rain pathogens injure the upper body, while cold-damp harms the lower body. These three types of pathogens affect different regions—I wish to understand their patterns." Qibo responded: "These three pathogenic categories differ in nature—some begin their affliction from the yin aspects..."

This passage explains how diseases gradually penetrate the human body from external to internal levels. The Yellow Emperor inquired with Qibo about the mechanisms of disease onset, and Qibo elaborated in detail on the pathways and manifestations of pathogenic invasion.

Disease occurrence is often related to emotional imbalances. When joy and anger become excessive and unregulated, they damage the internal organs, and such organ impairment generates illness from within. External dampness exploits these vulnerabilities to initiate disease from the lower body, while wind-rain pathogens attack from the upper body—these constitute the three primary entry points for disease invasion.

Qibo particularly emphasized that external pathogens like wind, rain, cold, and heat never cause disease alone. Those who encounter sudden storms yet remain unaffected do so because their vital Qi (Zhengqi) remains robust. Pathogens only succeed when the body's defenses are weakened. Disease formation requires two simultaneous conditions: abnormal climatic factors (deficient evil winds) and insufficient vital energy (physical weakness).

The invasion process follows clear stages: First, pathogens enter through the skin. When the skin is lax with open pores, they penetrate through body hair, initially causing skin prickling and piloerection. If pathogens persist:

• They first spread to the collaterals (fine vascular networks), causing muscle pain
• Then progress to the main meridians, inducing chills and susceptibility to fright
• Upon reaching the transport vessels (Qi-blood pathways), they trigger joint pain and stiff back
• When penetrating the deep Chong vessels, they produce heavy bodily aches
• In the intestines and stomach, they manifest as borborygmi and abdominal distension—cold exposure causing undigested-food diarrhea, heat leading to mucous stools

If pathogens remain, they may form accumulations between intestinal tissues or adhere to various vessels: minute Sun collaterals, Luo-connecting vessels, main meridians, transport vessels, deep Chong vessels, or even the paravertebral muscles and intestinal fasciae. The spreading pathways are complex and manifold, defying complete description.

When the Yellow Emperor pressed about accumulation formation, Qibo explained that when pathogens stagnate in Sun collaterals (the finest branching vessels), their narrow tortuous structure impedes Qi-blood flow, allowing pathogens to aggregate into palpable masses.

This passage explains the formation and causes of "accumulation disorders" (pathological aggregations) in the human body, interpreted in modern terms as follows:

When pathogenic factors linger in superficial areas like the arms or minute collaterals (Sunluo), they manifest as floating and weak pulses. If these pathogenic influences persist and accumulate, they migrate through the intestines and stomach, disrupting water metabolism. This results in gurgling sounds, abdominal distension upon exposure to cold, and intermittent cramping pain.

The manifestations vary depending on the location of the pathogenic accumulation:

• Near the Yangming Channel (Stomach Channel of Foot-Yangming), lumps form around the navel, becoming noticeable after eating and shrinking when hungry;
• In relaxed tendons (more slack muscle tissues), the condition resembles stomach channel accumulations, with pain after eating and relief during hunger;
• In the membrane-like tissues (Mu Yuan) between the intestines and stomach, pain radiates to the relaxed tendons, occurring when hungry and easing after meals;
• In the deep-seated Fuchong vessels, pulsations can be felt by hand, releasing heat that flows down the thighs like scalding water;
• Along the spinal muscles (Lü Jin), lumps are palpable when hungry but disappear after eating;
• In the transporting channels (Shu vessels), blockages occur, preventing body fluids from nourishing the orifices, leading to dryness and obstruction.

The Yellow Emperor inquired about the entire process of accumulation disorders from inception to formation. Qibo explained: It begins with exposure to cold, which disrupts Qi and blood flow, gradually forming accumulations. The specific progression is: cold ascends from the feet, causing calf chilliness → blood vessel stagnation → cold invading intestines and stomach → abdominal distension → coagulation of fluids and blood outside the intestines → eventual lump formation. Overeating or overexertion damages the collaterals, with injuries to different collateral networks causing varying bleeding symptoms (nosebleeds or bloody stools). When external cold combines with internal emotional disturbances (like worry or anger), Qi becomes chaotic, causing congealed blood and fluids to form various accumulations.

Finally, the text describes how emotional injuries affect different organs: grief harms the heart, severe cold damages the lungs, anger injures the liver, drunkenness during intercourse weakens the kidneys, and overwork combined with damp exposure stresses the spleen. These internal injuries all serve as underlying factors in accumulation disorder formation.

When a person is exposed to wind while sweating, it harms the spleen; excessive exertion or bathing after intercourse while sweating damages the kidneys. These are the causes of illness in the three internal and external regions (referring to the upper, middle, and lower jiao). The Yellow Emperor asked: "How should such conditions be treated?" Qibo replied: "Observe the location of the patient's pain to determine the corresponding ailment, and discern whether the qi and blood are in excess or deficiency. Supplement what needs supplementing, drain what needs draining, without violating the natural order—this is the optimal method of treatment."

In the chapter "On Needling Techniques," the Yellow Emperor asked Qibo: "I have listened to your explanations on the use of the nine needles (ancient acupuncture needles), but when applying them to ordinary people, I find that each person's qi and blood conditions differ. Some feel the effect as soon as their spirit is stirred; others experience qi arrival as soon as the needle is inserted; some continue to feel the qi even after the needle is withdrawn; others require multiple insertions before sensing anything; some experience rebellious qi immediately upon needling; and others worsen with repeated treatments. These six scenarios vary greatly—I wish to understand the principles behind them."

Qibo explained: "Those with abundant yang (particularly vigorous yang qi) are easily stirred in spirit, and their qi arrives swiftly." The Yellow Emperor asked: "What characterizes a person with abundant yang?" Qibo replied: "Such individuals are passionate and exuberant, speak rapidly, walk with high steps, have vigorous heart and lung qi, and their yang qi is abundant and radiates outward—thus, when their spirit is stirred, the qi arrives first." The Emperor pressed further: "Why do some with abundant yang not experience qi arriving first?" Qibo answered: "These individuals also exhibit notable yin qi. Observation reveals: those with more yang qi are often joyful, while those with more yin qi are prone to anger—though quick to calm—this being the hallmark of pronounced yin qi. In such people, yin and yang struggle to harmonize, hence the qi does not arrive first."

The Yellow Emperor continued his inquiry regarding other scenarios: "What causes qi to arrive simultaneously with the needle?" Qibo said: "This occurs when yin and yang are balanced, and the qi and blood flow smoothly—thus, the qi arrives as soon as the needle enters." The Emperor asked: "What about when the qi sensation persists after needle withdrawal?" Qibo explained: "This happens in those with more yin qi and less yang qi—where yin sinks while yang floats and remains latent within. Thus, the qi sensation lingers after withdrawal." The Emperor then asked: "What of those requiring multiple insertions before sensing anything?" Qibo replied: "Such individuals have excessive yin qi and deficient yang qi, causing sluggish qi movement—hence the delayed effect." Finally, the Emperor inquired: "What causes rebellious qi upon needling?" Qibo answered: "This stems from the patient's inherently disordered qi movement."

The Lingshu section of the Yellow Emperor's Inner Classic presents two clinical discussions on disease etiology and treatment methods.

Regarding "diaphragm disorder" (similar to modern esophageal or digestive tract obstruction), the Yellow Emperor first states his understanding that "upper diaphragm" (esophageal issues) causes immediate vomiting after eating, but expresses confusion about "lower diaphragm" (intestinal issues) where food is expelled only after a day. Qibo explains that this stems from emotional imbalances, irregular diet, and improper temperature regulation, allowing cold bodily fluids to accumulate in the intestines. Chilled intestines foster parasitic growth; these parasites gather in the lower digestive tract ("lower duct"), causing abdominal distension that blocks the flow of upright Qi (Zhengqi) while pathogenic Qi (Xieqi) lingers. During meals, parasites surge upward to compete for food, emptying the lower tract and enabling pathogenic Qi to form abscesses. Abscesses within the intestines trigger deep pain, while external ones cause superficial pain with skin fever. Treatment involves gently pressing the abscess to observe Qi movement, then shallow needling from the edges, gradually deepening—never exceeding three insertions. Post-needling, apply heat compresses to channel warmth inward, combine with dietary restrictions and emotional calmness, and administer salty-bitter herbs to aid digestion; the abscess will then dissipate.

Concerning sudden voice loss, Master Shaoshi clarifies to the Yellow Emperor: the pharynx is the food pathway, the larynx governs Qi circulation. The epiglottis serves as the "gate of sound," lips as its "fan," the tongue as the "mechanism of articulation," the uvula as the "sound switch," the nasopharynx (Hangsang) distributes Qi flow, and the hyoid bone (transverse bone), guided by spirit-energy (Shenqi), controls tongue movement. Persistent nasal discharge indicates nasopharyngeal blockage and disrupted Qi distribution. Those with thin, small epiglottises breathe swiftly, with agile opening-closing for easy phonation; thick, large epiglottises yield the opposite. This passage meticulously outlines the coordinated workings of human vocal organs.

This passage explains the pathology and treatment principles for sudden loss of voice. When cold pathogenic Qi invades the epiglottis (the cartilaginous tissue in the throat), it disrupts the normal opening and closing function of the epiglottis. The epiglottis can neither open properly to produce sound nor close completely, resulting in sudden muteness.

The Yellow Emperor asked about acupuncture treatment methods. Qibo replied: The Foot-Shaoyin Kidney Channel (one of the twelve primary meridians) ascends to connect with the tongue, passes through the hyoid bone, and ultimately reaches the epiglottis. If bloodletting is performed twice along this meridian, turbid Qi can be expelled. The meridian connected to the epiglottis ascends further to link with the Conception Vessel (Renmai, one of the eight extraordinary vessels). The Tiantu acupoint (located at the center of the suprasternal fossa) can be needled to restore normal epiglottis function.

The treatment principle described here involves stimulating relevant meridians and acupoints connected to the throat to dispel cold pathogens and restore normal epiglottal movement. Ancient physicians believed sound production was closely related to the Kidney Channel, hence selecting acupoints from both the Foot-Shaoyin Kidney Channel and the Conception Vessel for treatment.