The Yellow Emperor's Classic of Medicine — Essential Questions

Translation of Huangdi Neijing Suwen

Mingshan Yang, Jinghua Fu

• Publisher: WSPC
• Year: 2019
• ISBN:
  9789813273597
• Topic: Medicine
• Subtopic: Alternative & Complementary Medicine

Huangdi Neijing, also known as Yellow Emperor's Inner Classic, has played a pivotal role in traditional Chinese medical education for about two thousand years. The first part of Neijing which is called Suwen — Basic Questions or Essential Questions — covers the theoretical foundation of Chinese medicine as well as disease diagnosis and treatment. There are 81 chapters in a question-and-answer format between the mythical Yellow Emperor and his ministers. This translated book is based on the Chinese version annotated and edited by Jinghua Fu and his team, published by China Renmin University Press in 2010.

Contents:

• The Art of Health Cultivation in Ancient Times
• Great Theory on Spirit Regulation in Four Seasons
• Generative Qi Communicating with Nature
• Distinctive Words in the Golden Chest
• Great Theory on Yin–Yang Corresponding to Nature
• Separation and Combination of Yin and Yang
• Distinctive Theory on Yin and Yang
• Secret Cannon Stored in Numinous Orchid Chamber
• Six-Sixty System and Visceral Manifestations
• Comprehensive Generation of Five Solid Viscera
• Additional Theory on Five Solid Viscera
• Proper Therapies for Different Diseases Geographically
• Transferring Essence and Changing Qi
• Thin and Thick Medical Wine
• Fundamental Theory Inscribed in Jade
• Diagnostic Essentials and Manifestations of Twelve-Meridian Exhaustion
• Diagnosis for Pulse-Taking and Pulse Subtlety
• Pulse-Qi Conditions of Healthy Person
• Vital Theory on Critical Visceral Pulses Inscribed in Jade
• Three Regions and Nine Positions of Pulse
• Distinctive Theory on Meridians and Diseased Pulses
• Transference of Solid Visceral Qi Following Regularity of Four Seasons
• Clarification of Five-Visceral Qi
• Blood, Qi, Body and Emotions
• Cherishing the Life and Guarding the Body
• Eight Solar Terms and Medical Perspective
• Separation and Combination of Genuine Qi and Evil Qi
• Comprehensive Theory on Deficiency and Excess
• Taiyin and Yangming Meridians
• Explanation on Yangming Meridian
• Heat-Disease
• Treatment of Heat Disease with Acupuncture
• Commentary on Heat Disease
• Disharmony of Diseases
• On Malaria
• Theory on Acupuncture for Malaria
• Qi Reversal
• Cough
• Listing and Analyzing Pain-Disease
• Abdominal Disorders
• Treatment of Lumbago with Acupuncture
• Wind Evil
• Impediment Syndrome
• Flaccidity Syndrome
• Reversal Syndrome
• Manifestations of Seven Diseases
• Uncommon Diseases
• Extraordinary Diseases
• Explanations of Twelve-Meridian
• Keys of Needling
• Restrictions of Needling
• Contraindications of Acupuncture
• Notes of Needling
• Explanation of Needling
• Extension of Needling Manipulation
• Skin Regions
• Meridians and Collaterals
• Qi-Acupoint
• Qi-House
• Bony Foramen
• The Acupoints for Water-Disease and Heat-Disease
• Regulation of Meridians
• Contralateral Needling
• Needling for Reversing or Complying with the Changes in Four Seasons
• Branch–Root and Transmission of Diseases
• Great Theory on Law of Primordial Qi in Nature
• Great Theory on Movement of Five Phases
• Great Theory on Movement of Six-Qi
• Great Theory on Shifting and Interaction of Qi
• Great Theory on Routine Functions of Five Phases
• Great Theory on Normality of Six-Qi
• Acupuncture Therapy for Abnormal Qi-Phase
• Root of Diseases
• Great Theory on Crucial Principles
• Elucidation of Perfect Teaching
• Administration of Reasonable Analysis
• Listing and Analysis of Five Diagnostic Errors
• Precautions for Four Diagnostic Faults
• Categorization of Yin and Yang
• Measurement of Exuberance and Exhaustion
• Explanation of Subtleties of Essence
• Appendix A: Acupuncture Therapy for Abnormal Qi-Phase
• Appendix B: Root of Diseases

Readership: Medical practitioners who use alternative medicine or are interested in Traditional Chinese Medicine.Chinese Medicine;Healthcare;Huang Di's Innner Classic;Yin and Yang00

Chapter 1

The Art of Health Cultivation in Ancient Times

The Yellow Emperor lived in ancient China. He was born with high intelligence; as a toddler, he was able to talk well; as a child, he was quick in understanding of things; later, in his younger days, he was honest and nimble; finally, in his adulthood, he was accomplished and became the Emperor.

The Emperor asked Master Qibo: I’ve heard that people in ancient times could live to about one hundred years without decline in action, but today I see people doddering much earlier from the age of fifty! Is it due to the change in era or the loss of health cultivation?

Qibo answered: People in ancient times knew the way to cultivate their health and followed the rules of Yin and Yang; they kept fit with exercises, moderate eating and drinking, led a routine daily life, and avoided overstrain or sexual intemperance. Thus, this helped them integrate their soul and body and enjoy a natural life span, and meet their peaceful end at the age of about one hundred. Today, people behave oppositely. They drink wine as though it were water, regard indulgence as normal and seek sexual pleasure after being drunk, so their essence of life is exhausted and the genuine Qi is dissipated. They don’t know how to maintain maximum health or control their minds; they do whatever they like while violating the tenets of life, and live an irregular daily life; they appear to be aging much faster, and visible signs of aging are seen as early as in their fifties.

When teaching people in ancient times, the sages will mention that all deficient evil and sinister wind should be avoided in time, and people should cultivate a quiet mind against any distractions, which can thus help soothe the genuine Qi and guard their spirits intact. Thus how can any diseases develop? Therefore, people can live a peaceful life with fewer desires, make their mind stable with no anxiety, and perform physical labor without much fatigue, so that their Qi can flow smoothly such that they can meet their satisfaction according to their proper wishes. Then people can enjoy whatever food they eat, feel ease with whatever clothes they wear, enjoy themselves in their customs, and never make upward social comparison; they were really plain honest people. Therefore, no addiction can distract their attention, and no lust can disturb their mind. Whether being intelligent or ignorant, and moral or unworthy, they are not anxious about materialistic living and can attain the status prescribed in ancient laws. The reason why people in ancient times lived up to one hundred years without any aging in action was that they mastered the way of health cultivation beyond illness.

Emperor: Elderly people are unable to give birth to any child. Is it due to the exhaustion of the essence or the natural law of physiology?

Qibo: For a female, her kidney Qi becomes exuberant at the age of seven when permanent teeth erupt and hair starts growing long. Menarche occurs at the age of fourteen when the Conception meridian starts opening up, followed by the exuberance of the Thoroughfare meridian resulting in regular menstruation cycle; the woman thus becomes fit to conceive a child. She has plentiful kidney Qi at the age of twenty-one, when her wisdom teeth erupt leading to permanent dentition. At the age of twenty-eight, her sinews and bones become firm, the hair grows long enough and the physique attains peak condition. At the age of thirty-five, her Yangming meridian starts to decline, her face begins to wither and hair starts to fall. At the age of forty-two, there is deficiency in triple-Yang meridians from upward while the face withers completely and the hair turns white. At the age of forty-nine, there is deficiency in both Conception and Thoroughfare meridians, menopause occurs leading to exhaustion in the reproductive essence, so that her body looks shapeless and loses the ability to bear a child.

For a male, his kidney Qi starts getting enriched at the age of eight when hair starts to grow and permanent teeth erupt. At the age of sixteen, his kidney Qi is exuberant signaling the arrival of the reproductive essence, and his spermatic essence too overflows. If Yin and Yang are harmonized, a male is able to bear a child. At the age of twenty-four, his kidney Qi is plentiful and he has firm sinews and bones, the wisdom teeth erupt leading to permanent dentition. At the age of thirty-two, his sinews and bones become stout and muscles become strong. At the age of forty, his kidney Qi falls into a decline, with hair loss and withering teeth. At the age of forty-eight, his Yang Qi declines from upward when his complexion withers and the hair on the temples turns white. At the age of fifty-six, his liver Qi declines further and the sinews become rigid while the reproductive essence is exhausted with less spermatic essence due to kidney Qi decline; his physique and body functions deteriorate. At the age of sixty-four, his teeth and hair are gone. The kidney governs water, receives and stores the essence from five solid and six hollow viscera, and discharges the excess when five solid viscera are substantially full. These five solid viscera degenerate when the sinews and bones become flaccid, and the reproductive essence is exhausted. So his earlock turns white, the body becomes clumsy, the walking develops a doddering pattern and he is therefore unable to bear a child.

Emperor: But some elderly people are still able to conceive a child. How do you explain this phenomenon?

Qibo: This is because they have a robust natural constitution, the circulation of both Qi and blood is always smooth and their kidney Qi is richer. Nevertheless, the age for a male to have a child is no more than sixty-four, and for a female, no more than forty-nine, beyond which the essence Qi of Yin and Yang is completely exhausted.

Emperor: Those who have complied with the law of health cultivation live over one hundred years. Can they bear a child?

Qibo: Those who have complied with the rule of health cultivation can delay aging and keep fit; although aged, they can still bear a child.

Yellow Emperor: I’m told that in ancient times there were Immortals, who could adapt to the changes of nature, comply with the law of Yin–Yang, inhale ‘vital air’, guard their spirits independently and keep their muscular structure integrated, so they could live with heaven and earth having endless span, and this is the outcome of living according to the way of life. In the middle ancient times, there were Perfect Men, who had superior moral values and mastered health cultivation, harmonized their Yin–Yang, adapted themselves to four seasons, abandoned worldly interests, and concentrated their spirits, as if they could travel between the heaven and the earth and see or hear beyond eight directions. This was their way to extend life span, become stronger and attain immortal status. Next, there were Sages, who lived in the harmony of the heaven and the earth and followed the rules of eight winds. They moderated their interests and desires in the secular world and freed themselves from anger and complaints. They had no intention to separate themselves from common life; even though they wore common clothes, they never followed the behavior of ordinary people. Physically, they didn’t exhaust themselves and spiritually they didn’t worry themselves; they regarded peace and happiness as their life goals and self-gratification as the accomplishment. As a result, their bodies weren’t susceptible to decline and their spirits did not dissipate. Therefore, they were able to live to about one hundred years. Finally, there existed Virtue Men, who maintained their health in accordance with the laws of the heaven and the earth, with changes of the sun or moon and shifting of the stars; they complied with the alteration of Yin–Yang and four seasons such that they could prolong the life as long as possible.

Chapter 2

Great Theory on Spirit Regulation in Four Seasons

The three months of spring is the period for growing the new, instead of the old, when the heavens and the earth are resuscitating and all the living things are flourishing. People will sleep late at night and get up early in the morning to walk in the courtyard with hair untied and body relaxed, so as to refresh their spirit. In this period, one should prefer growing to killing, promotion to punishment and giving to depriving, which is just the adaptation to spring Qi and also the rule of health cultivation for generating Qi. Reversing the rule impairs liver, which will lead to excessive cold diseases in summer due to insufficient supply for growth.

The three months of summer is the period for prosperity when heavenly Qi and earthly Qi are mingling and all the living things are in fruitful blossom. In this period, people sleep late at night and get up early in the morning without being tired of long daytime, avoid angry mood as if being in floral exuberance to make Qi communication smooth and enjoy the outer world. This is just the adaptation to summer Qi and also the rule of health cultivation for growing Qi. Reversing the rule impairs heart, which will lead to malaria in autumn due to insufficient supply for collection and the exacerbation in winter.

The three months of autumn is the period for peace and maturation when the wind is strong and the air over the earth is clear and bright. People sleep early at night and get up early in the morning when hearing the crow of a rooster, to keep the spirit calm for separating oneself from the conquering sough of autumn, to astringe the spirit and energy internally for balancing the autumn Qi, and to guard the mind against anxiety for clearing lung Qi. This is just the adaptation to autumn Qi and also the rule of health cultivation for collecting Qi. Reversing the rule impairs lung, which will lead to diarrhea after indigestion in winter due to insufficient supply of Qi for storage.

The three months of winter is the period for closure and storage when the water freezes and the earth cracks. People should not disturb Yang Qi, and go to bed early at night and get up late in the morning to wait for the rising sunlight and to make the spirit hidden or concealed as if having the privacy or keeping it for one’s own. They should dispel cold and keep warm, avoid discharge from the skin and exhaustion of Qi. This is just the adaptation to winter Qi and also the rules of health cultivation for storing Qi. Reversing the rule impairs kidney, which will lead to loss of vigour in spring due to insufficient supply of Qi for generation.

Heavenly Qi is clear and bright, which can embrace the natural power ceaselessly so that all the living things won’t subside. If the heavens are too brilliant, the sun and moon will seem dim and evils will attack the hollow orifices. If Yang Qi is blocked, earthly Qi glooms while the cloud and mist cannot obtain the essence, so the corresponding dew upward won’t fall. If the heavens and the earth fail to communicate with each other, all the living things will lose their vitality, in which even precious trees will die mostly. If bad Qi isn’t dispelled, the wind and rain cannot be regulated and the dew cannot fall, because of which grasses and trees will wither. The evil wind attacks frequently and rainstorm often sweeps in which the heavens and the earth as well as four seasons lose their orders to reverse the law of nature and even lead to early death. Only the sages can follow the law of nature, so they won’t contract any rare diseases. Similarly, if all the living things follow the law, their vitality will never be exhausted.

If spring Qi is reversed, Shaoyang Qi fails to be born and then liver Qi will be changed abnormally and internally. If summer Qi is reversed, Taiyang Qi will fail to develop and then heart Qi will become empty internally. If autumn Qi is reversed, then Taiyin Qi fails to be astringed, leading to dryness and feverish distension of lung Qi. If winter Qi is reversed, then Shaoyin Qi fails to be stored, leading to sinking of kidney Qi alone.

The change of Yin and Yang in four seasons is the root of all the living things in nature. The sages can cultivate Yang energy in spring and summer while nourishing Yin energy in autumn and winter to comply with the root of the nature, so that they can live with the rule of all the living things. If one reverses the law, the root of life will be felled and the primordial Qi will be destroyed. Therefore, the change of Yin and Yang in four seasons is fundamental to all the things in nature and is the root of birth and death. The reversal will cause disasters while compliance will lead to no disorder, which is known as enlightenment of law. The law of health cultivation will be followed by the sages but the foolish will violate.

Compliance with the law of Yin and Yang will protect life, while reversing it will cause death; compliance with the law will bring about peace, while reversing it will cause disorders. Reversing the common law is known as internal rejection. Therefore, the sages will not always focus on the treatment of the developed disease but will emphasize treating the predisease state; they will not focus on the treatment of the developed disorder but will emphasize treating the pre-disorder state. After the disease has been developed, it is given medication, or after the disorder has been formed, it is given treatment; this is just like digging a well when one feels thirst, or making weapons when a war is breaking out. Isn’t it too late?

Chapter 3

Generative Qi Communicating with Nature

Yellow Emperor: The communication with heavenly Qi has been considered to be fundamental to life since ancient times, which is in turn based on Yin and Yang. Between the heavens and the earth, or within six directions of the universe, Qi exists in nine states, in nine orifices, five solid viscera and twelve joints of the body, all of which communicate with heavenly Qi. Yin–Yang generates five elements, which in turn correspond to triple-Yin and triple-Yang. If people frequently violate the rule, evil Qi will impair their bodies, which is the root of long life.

If heavenly Qi is fresh and clear, people can maintain a peaceful mind and comply with it to strengthen Yang Qi. Even the evil around cannot impair the body, which is due to adaption to the seasonal order. Therefore, the sages can keep the essence of Yin and Yang to comply with heavenly Qi, and thus are able to communicate with the deities. If this is reversed, the evil will block the nine orifices internally and congest muscles externally, leading to dispersion of the defensive Qi, which is called self-impairment with Qi damaged.

Yang Qi is just like the sun in the heavens, and if the essential sun is lost, it will lead to reduction of life and insufficient vitality. Therefore, the normal movement of the heavens depends on the brightness of the sun. So, Yang Qi will be ascending, which can defend the body against external evils.

Affected by cold, the desire is like a running pivot, and if there is much unease in daily life, the spirit Qi will float. Affected by summer heat, the body sweats with vexation and the person pants loudly even while speaking and at rest. When the body develops high fever as if being a burning coal, the stagnated heat can be dissipated with perspiration. Affected by damp, the head will have a feeling of being wrapped. If the damp heat isn’t dispelled, the large sinew will become short while the small one will become loose, the former displaying a constricted pattern and the latter a flaccid pattern. Affected by wind, swelling will develop while four evils will attack four limbs alternatively, leading to exhaustion of Yang Qi.

Yang Qi will be hyperactive during vexation or overworking, and essence Qi will be exhausted when the disease is lingering in summer, which may bring out the hot reversal.

The blind loses sight and the deaf loses hearing, just like the raging torrent through a breached dyke, which is impossible to be checked.

Yang Qi will divorce the physique Qi in a rage, while blood will stagnate in the upper region, resulting in sudden syncope. If impaired, the sinew will become flaccid and disabled, and if not held, there will be sweating over half of the body, leading to hemiparalysis. If sweating is complicated by the invasion of damp, it will cause boils or prickly heat. Too much fatty and refined food tends to cause big boils on foot, which is just like putting something in the empty. When the body is attacked by wind when working with sweat, cold evil will invade the skin to cause roughness and stagnation, leading to acne.

With the nourishment of Yang Qi, the spirit can be nourished by its essence and the sinew can be nourished by its gentle part. With abnormal opening and closing of interstitial striae, the cold evil will invade and result in humpback. The intrusion into vessels will result in fistula, which has lingered between the muscle and interstitial striae. Cold Qi invading through acupoints will attack the viscera in transmission, which may cause susceptible fear and fright. If the nutrient Qi fails to flow normally and stagnates in the muscular interstices, it will result in carbuncle and swelling. When evaporation of Yin-sweat isn’t enough, the physique will be weak and Qi will be exhausted while acupoints will be closed, leading to wind-malaria. Therefore, wind is the leading cause of various diseases. However, only if people can keep a quiet mind and moderate workload, the muscular striae can be closed and even the violent wind or toxin cannot cause damage, which is in compliance with the seasonal changes.

So, prolonged diseases tend to transmit and change. Then, when the upper and the lower cannot communicate, even a good doctor can do nothing about it. Therefore, the accumulation of Yang Qi will lead to disorder and even death while Yang Qi has been blocked. The blocked Yang Qi should be purged. If the treatment cannot be given immediately and properly, the patient will die. So, Yang Qi governs the exterior in the daytime. Yang Qi begins to emerge at the crack of dawn, grows into exuberance at noon and becomes feeble at dusk, thus closing the sweat pores. Hence, at dusk, Yang Qi is astringed, during which time the sinews and bones shouldn’t be disturbed, and the body should avoid being exposed to fog and dew. Any violation in the three sequences can encumber the physique.

Qibo: Yin can keep the essence inside, which can play a vital role, and Yang can protect the exterior and consolidate it. If Yin is dominated by Yang, the pulse will be strenuous and rapid, leading to drastic diseases. If Yang is dominated by Yin, Qi of five solid viscera will conflict one after another so as to block the nine orifices. Hence, the sages can balance Yin and Yang to harmonize the sinews and vessels, strengthen the bone and marrow, and smoothen Qi and blood flow. Thus, the internal and the external can be harmonized and the evil cannot impair the body, so that people can maintain good sight and hearing and Qi can circulate normally as usual. With wind invading and Qi disturbed, the evil will impair liver when Yin essence has been exhausted. So, overeating will make sinews and vessels flaccid, which will cause dysentery and hemorrhoids. So, overdrinking will cause Qi to flow reversely. Overexertion or excessive intercourse will impair kidney Qi and even injure the lumbar spine.

The fundamental of Yin and Yang is that only when Yang is compact can Yin be consolidated. If there is no harmony between Yin and Yang, it is as if there were spring but no autumn, or winte...