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Huangdi Neijing · The Yellow Emperor’s Inner Canon
Lingshu 74 · Diagnosing Illness through the Chi Region
Read in English. Switch to Original for word notes, or select text to ask a question.
The Yellow Emperor asked Qi Bo: “I wish to describe illness without inspecting color or holding the pulse, using only the chi region to know the interior from the exterior. How is this done?”
Qi Bo said: “Examine the chi region for relaxation or tension, size, slipperiness or roughness, and firmness or brittleness of flesh: the form of illness is established.
“Slight swelling above the eye sockets, like someone just risen from sleep, with moving neck vessels, occasional cough and pressure on hands and feet leaving a hollow that does not rise, indicates wind-water and skin distension. Slippery, soft and moist chi skin indicates wind. Weak chi flesh indicates slack fatigue. A wish to lie down with wasting flesh indicates cold and heat declared beyond treatment. Slippery chi skin with oily luster indicates wind; rough skin, wind obstruction. Skin coarse as dried-fish scales indicates overflowing water and retained drink.
“Extremely hot chi skin with an abundant, agitated pulse indicates warm illness. An abundant, slippery pulse means illness is about to emerge. Cold chi skin with a small pulse indicates diarrhea and scant qi. Chi skin first blazing hot then cold indicates cold and heat; skin first cold and becoming hot after prolonged enlargement or examination likewise indicates cold and heat.
“Heat only at the elbow indicates heat above the waist; only at the hand, below the waist. Heat only in front of the elbow indicates the front chest; behind it, shoulder and back. Heat only in the middle arm indicates waist and abdomen. Heat in the coarse region three or four cun below the back of the elbow indicates worms in the intestines. Heat in the palm indicates abdominal heat; cold in the palm, abdominal cold. Blue-green blood vessels in the pale flesh above the fish region indicate cold in the Stomach.
“Blazing heat in the chi region with large Renying calls for removal of blood. A firm, large chi region with an extremely small pulse, scant qi and increasing oppression is declared to bring immediate death.”
The supplied illness-about-to-emerge wording, enlarged-or-examined phrase and three-or-four-cun location are retained despite variant readings. The chi region is the historical forearm diagnostic region; its correspondences and prognosis are not modern validated tests.
Red eyes indicate Heart illness; white, Lung; blue-green, Liver; yellow, Spleen; black, Kidney. Yellow that cannot be distinctly named indicates illness in the chest.
In examining eye pain, red vessels descending from above indicate Taiyang illness; ascending from below, Yangming; running inward from outside, Shaoyang. In examining cold and heat, red vessels passing above and below through the pupil give these predictions: one vessel, death in one year; one and a half, in one and a half years; two, in two years; two and a half, in two and a half years; three, in three years.
In examining painful decayed teeth, press where their yang qi arrives. The disordered place alone is hot: left illness gives left heat, right gives right heat, upper gives upper heat and lower gives lower heat.
The complete eye-vessel count and year sequence remain historical prognoses, not a prediction for a present patient.
In examining blood vessels, much red means much heat; much blue-green, much pain; much black, longstanding obstruction. Red, black and blue-green appearing together indicate cold and heat with bodily pain. A slightly yellow complexion, yellow tooth deposits and yellow nails indicate jaundice. A wish to lie down, yellow-red urine and a small, rough pulse accompany lack of appetite.
When a sick person’s Cunkou and Renying pulses are equal in size and in floating or sinking, illness is hard to end. Marked movement of a woman’s Hand Shaoyin pulse indicates pregnancy. In a sick infant, all head hair turning upward is declared fatal. Raised blue-green vessels by the ears indicate pulling pain. Red fragments in the stool with diarrhea of undigested food, a small pulse and cold hands and feet are hard to end. With undigested-food diarrhea and a small pulse but warm hands and feet, the diarrhea is easy to end.
The supplied red-fragment graph is uncertain, with differing older color and fragment readings. The pregnancy and infant predictions remain the text’s assertions without modern diagnostic confirmation.
In seasonal transformation and the predominance of cold and summer heat, doubled yin must become yang and doubled yang yin. Yin governs cold and yang heat; extreme cold therefore becomes heat and extreme heat cold. Thus cold gives birth to heat and heat to cold: this is yin and yang’s transformation. Injury by cold in winter produces burning heat in spring. Injury by wind in spring produces undigested-food diarrhea and intestinal flux in summer. Injury by summer heat produces intermittent fever in autumn. Injury by damp in autumn produces cough in winter. This is called the ordering of the four seasons.
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