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Huangdi Neijing · The Yellow Emperor’s Inner Canon
Lingshu 66 · The Beginning of the Many Illnesses
Read in English. Switch to Original for word notes, or select text to ask a question.
The Yellow Emperor asked Qi Bo: “The many illnesses begin in wind and rain, cold and summer heat, cool damp, joy and anger. Unrestrained joy and anger injure the zang; wind and rain injure above; cool damp injures below. The qi of these three divisions causes different kinds of injury. I wish to hear how they meet.”
Qi Bo said: “The qi of the three divisions differs, some arising in yin and some in yang. Let me describe their patterns. Unrestrained joy and anger injure the zang, so illness arises in yin. Cool damp attacks emptiness, so illness arises below. Wind and rain attack emptiness, so illness arises above. These are the three divisions; their excessive spreading cannot be counted.”
The Yellow Emperor said: “Because I cannot count them, I ask the earlier teacher. I wish to hear their course in full.”
Qi Bo said: “Wind and rain, cold and heat cannot injure a person alone without an empty harmful condition. Those who suddenly meet swift wind and violent rain yet do not become ill have no emptiness; hence harmful influence cannot injure them alone. Empty harmful wind and the person’s bodily form must meet as two emptinesses before it lodges in the body. When two replete conditions meet, people’s flesh is firm.
“Being struck by an empty harmful influence depends on heavenly timing and bodily form, with emptiness and repletion considered together, before great illness forms. Qi has a settled dwelling and is named according to its place. Above and below, within and outside, it is divided into three regions.”
The final spatial categories are compressed in the source; its stated three regions are retained rather than replaced with a new count.
Thus an empty harmful influence first strikes the skin. When skin relaxes, the interstices open and influence enters along the hairs. Entering, it reaches deeper; hairs stand up, shivering occurs and the skin hurts.
If it remains, it transfers its dwelling to the networks. In the networks it causes flesh pain; the pain rests at times and the great channels take over. If it remains, it transfers to the channels, causing shivering and easy fright. Remaining, it transfers to the transporting courses. The six qi then cannot reach the four limbs; limb joints hurt and waist and spine stiffen.
Remaining, it transfers to the hidden Chong vessel, bringing bodily heaviness and pain. Remaining, it transfers to intestines and Stomach, bringing surging noises and abdominal distension. With much cold, intestines rumble and undigested food passes in diarrhea; with much heat, gruel-like loose stools emerge.
If it remains without emerging, it transfers outside intestines and Stomach to the membrane-source region and adheres to vessels. Lingering without leaving, it grows into an accumulation. It may adhere to minute vessels, networks, channels, transporting vessels, the hidden Chong vessel, spinal sinews, or the membrane source of intestines and Stomach, linking above to the relaxed sinews. Such excessive spreading cannot be fully discussed.
The membrane source and relaxed sinews retain the text’s historical region names without substitution of a modern tissue identification.
The Yellow Emperor said: “I wish to hear fully why these happen.”
Qi Bo said: “An accumulation adhering to minute network vessels travels upward and downward. The minute networks’ dwellings in arm and hand are superficial and relaxed and cannot hook and hold the accumulation, so it moves back and forth between intestines and Stomach. Water gathers, seeps and pours into it with splashing sounds. Cold brings surging fullness and rumbling, pulling discomfort, hence intermittent cutting pain.
“Adhering to the Yangming channel, it stays beside the navel, enlarging after a full meal and shrinking with hunger. Adhering to the relaxed sinews, it resembles a Yangming accumulation but hurts after a full meal and is quiet with hunger. Adhering to the membrane source of intestines and Stomach, it hurts and links outward to the relaxed sinews: a full meal quiets it, hunger causes pain.
“Adhering to the hidden Chong vessel, it moves in response to the palpating hand; when the hand is lifted, hot qi descends into both thighs like hot water poured over them. Adhering to the spinal sinews behind the intestines, it appears with hunger and disappears after a full meal and cannot be found by pressure. Adhering to a transporting vessel, it closes passage; jin and ye fluids do not descend and the openings become dry and blocked. This is harmful qi entering from outside inward and from above downward.”
The supplied arm-and-hand wording in the first account sits awkwardly beside its abdominal course. It is retained without silently replacing it with a different anatomical reading.
The Yellow Emperor said: “How does an accumulation proceed from its beginning until it is formed?”
Qi Bo said: “Its beginning comes from receiving cold; reversal then forms the accumulation.”
The Yellow Emperor said: “How is the accumulation formed?”
Qi Bo said: “Reversal qi brings discomfort in the feet, followed by cold shins. Cold shins make blood vessels congeal and become rough. Cold qi then rises into intestines and Stomach, producing surging distension. Juices and froth outside the intestines are pressed together and cannot disperse, gradually forming an accumulation.
“Suddenly eating and drinking much fills the intestines. Irregular activity and excessive exertion injure the networks. Injured yang networks spill blood outward, producing nosebleed. Injured yin networks spill blood inward, producing bleeding below. Injured intestinal and Stomach networks spill blood outside the intestines. With cold there, juice, froth and blood strike together, combine, congeal and cannot disperse, completing an accumulation.
“Sudden external cold, or internal injury by anxiety and anger, makes qi counterflow upward. The six transporting courses then close and warm qi cannot move. Congealed blood becomes wrapped and retained without dispersing; jin and ye fluids seep roughly, adhere and remain. In this way accumulations form.”
The Yellow Emperor said: “What of illness arising in yin?”
Qi Bo said: “Anxiety and thought injure the Heart. Repeated cold injures the Lung. Rage injures the Liver. Entering the bedchamber drunk and meeting wind while sweating injure the Spleen. Excessive exertion, or bathing after intercourse while sweating, injures the Kidney. These are the illnesses arising from the three divisions, internal and external.”
The Yellow Emperor said: “Good. How is it treated?”
Qi Bo replied: “Examine the painful place to know its correspondence and its excess or insufficiency. Supplement what should be supplemented and drain what should be drained. Do not oppose heavenly timing. This is called the highest treatment.”
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