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Huangdi Neijing · The Yellow Emperor’s Inner Canon
Suwen 43 · Obstruction
Read in English. Switch to Original for word notes, or select text to ask a question.
The Yellow Emperor asked: “Where does bi obstruction arise?”
Qi Bo replied: “Wind, cold and dampness arrive mixed and combine to form obstruction. Predominant Wind qi produces moving obstruction; predominant cold painful obstruction; predominant dampness fixed obstruction.”
The Emperor asked: “Why are there five forms?”
Qi Bo said: “Encountering these influences in winter produces bone obstruction; in spring sinew obstruction; in summer vessel obstruction; in utmost yin flesh obstruction; in autumn skin obstruction.”
The Emperor asked: “What qi makes it lodge internally in the five zang and six fu organs?”
Qi Bo said: “Each of the five zang organs has a corresponding tissue. Illness persisting without leaving lodges inwardly in that tissue’s corresponding organ. Bone obstruction that does not end, with further harmful influence, lodges in Kidney; sinew obstruction in Liver; vessel obstruction in Heart; flesh obstruction in Spleen; skin obstruction in Lung. These obstructions arise through repeated encounters with Wind, cold and damp qi in their respective seasons.”
When obstruction lodges in the five zang organs, Lung obstruction brings vexation, fullness, panting and vomiting. Heart obstruction obstructs the vessels; vexation brings drumming below Heart and sudden upward qi with panting, dry throat and frequent belching. When counterflow qi rises, fear follows.
Liver obstruction brings startlement when lying at night, much drinking and frequent urination, with upward drawing fullness as though carrying a child. Kidney obstruction frequently causes distention: the buttocks take the place of the heels and the spine the place of the head. Spleen obstruction brings slack, fallen limbs, cough and vomiting of fluid, with great obstruction above.
Intestinal obstruction brings frequent drinking without ability to discharge, with central qi panting and contending, and occasional flux of undigested food. Obstruction of the receiving sac brings pain within the lower abdomen and Bladder on pressure, as though hot water were poured there, difficult urination and clear nasal mucus above.
Yin qi at rest allows spirit to be stored; when agitated, it dissipates and disappears. Doubling one’s food and drink injures intestines and Stomach.
Excessively spreading qi with panting: obstruction gathers in Lung. With worry and thought: in Heart. With involuntary urination: in Kidney. With exhaustion: in Liver. With wasting flesh: in Spleen. Persistent obstruction progresses further inward. When Wind qi predominates, the person recovers more easily.
The Emperor asked: “Why does obstruction sometimes cause death, sometimes prolonged pain and sometimes easy recovery?”
Qi Bo said: “Entry into the zang organs means death. Lingering between sinews and bones causes prolonged pain. Remaining between the skin layers allows easy recovery.”
The Emperor asked: “How does it lodge in the six fu organs?”
Qi Bo said: “Food, drink and dwelling conditions are likewise its root. Each of the six fu organs has transport sites. Wind, cold and damp qi strike those sites; food and drink respond to them. The influences enter along the transport pathways and lodge in the respective fu organ.”
The Emperor asked: “How is it treated with needles?”
Qi Bo said: “The five zang organs have transport points and the six fu organs he-sea points. Follow the divisions of the vessels; each has places where its influence emerges. Follow each excess or fault, and the illness recovers.”
The Emperor asked: “Can nutritive and defensive qi also produce obstruction?”
Qi Bo said: “Nutritive qi is the refined qi of water and grain. Harmonized in the five zang organs and spread through the six fu organs, it can enter the vessels. Thus it follows them upward and downward, passes through the five zang organs and networks with the six fu organs.
Defensive qi is the fierce qi of water and grain. Swift, forceful, slippery and freely moving, it cannot enter the vessels. Thus it follows inside the skin and between divisions of flesh, permeates the huang membranes and disperses through chest and abdomen. Opposing its qi causes illness; following it brings recovery. It does not combine with Wind, cold and damp qi, so does not itself produce obstruction.”
The Emperor said: “Good. Why is obstruction sometimes painful, sometimes painless or numb, sometimes cold or hot, dry or damp?”
Qi Bo said: “Pain means abundant cold qi: cold causes pain. Painless numbness means longstanding illness has entered deeply. Nutritive and defensive qi move roughly; channels and networks are at times depleted and therefore obstructed. Skin is not nourished, producing numbness.
Cold obstruction means scant yang qi and abundant yin qi, which reinforces the illness and produces cold. Hot obstruction means abundant yang qi and scant yin qi; illness qi prevails and yang encounters yin, producing obstructive heat. Profuse sweat and wetness mean severe exposure to dampness. Yang qi is scant and yin abundant; the two qi interact, so sweat emerges and wets the body.”
The Emperor asked: “Why can the illness of obstruction be painless?”
Qi Bo said: “Obstruction in bone causes heaviness; in vessels, blood congeals and fails to flow; in sinews, bending without extension; in flesh, numbness; in skin, cold. With these five manifestations, there is no pain. In obstruction generally, encountering cold brings a crawling sensation; encountering heat brings slackness.
Reading note: Crawling follows Wang Bing’s gloss of 蟲 as a feeling like insects moving under the skin, rather than silently replacing the supplied graph with another edition’s urgency reading.”
The Emperor said: “Good.”
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