素问·生气通天论 Discourse on How the Generative Qi Communicates with Heaven

Huangdi said: 'Since ancient times, communication with Heaven has been the root of life; this root lies in yin and yang. Within Heaven and Earth, within the six directions, the qi of the nine provinces, the nine orifices, the five viscera, and the twelve joints of the limbs — all communicate with the qi of Heaven. It gives birth to the five phases, and its own qi is threefold, the three yin and three yang. Those who repeatedly violate these principles will be injured by evil qi — this is the very root of long life. When the qi of the blue Heaven is pure and tranquil, the will and mind are well ordered; if one accords with this, the yang qi becomes firm, and even though thieving evils may be present, they cannot cause harm — this comes from following the sequence of the seasons. Therefore the sage transmits his essence and spirit, takes in the qi of Heaven, and thereby communicates with spiritual brilliance. If he loses this, then within, the nine orifices become blocked, and without, the flesh and muscles become congested; the defensive qi scatters and dissolves — this is called self-injury, a whittling away of one's qi.'

The yang qi of the body is like Heaven and the sun: if it loses its proper place, one's life is shortened and one's vitality fails to shine forth. Just as the motion of Heaven depends on the brightness of the sun, so does the body's vitality depend on its yang qi. Thus yang qi, by its nature, rises upward and guards the exterior. When affected by cold, the yang qi ought to move like a turning door-pivot; if instead one's rising and resting are as agitated as if startled, the spirit qi will float upward and scatter. When affected by summer-heat, excessive sweating brings panting and gasping; if the person is still, there is much talking; the body feels as if scorched like burning charcoal, and only when sweat is released does the heat disperse. When affected by dampness, the head feels as if wrapped in a cloth; if the damp-heat is not dispelled, the large sinews contract and shorten while the small sinews become slack and lengthen — contraction and shortening cause spasm, while slackness and lengthening cause wilting weakness. When affected by pathogenic qi, swelling occurs; when the four limbs are afflicted in turn, the yang qi becomes exhausted.

When yang qi is overtaxed through vexation and overwork, it becomes overextended; the essence becomes exhausted and accumulates repeatedly, and in summer this causes a person to suffer 'scorching reversal.' The eyes become blind and unable to see, the ears become blocked and unable to hear — the condition collapses like a ruined dam, gushing forth uncontrollably, impossible to stop. When yang qi is affected by great rage, the body's qi becomes cut off, and blood congests in the upper body, causing a person to suffer 'assaulting reversal.' If the sinews are injured and become slack, as though they can no longer contain the body properly, and sweating occurs unevenly on one side, this causes a person to become paralyzed on one side. If sweat is exposed to dampness, boils and heat-rash are produced. Excessive consumption of rich food and fine grains gives rise to large carbuncles in the extremities, striking a person as easily as emptying a vessel. Sweating from exertion, when exposed to wind, and chilled and constricted, produces acne-like eruptions, which when stagnant become boils.

When yang qi is properly refined, it nourishes the spirit; when it is properly soft and pliant, it nourishes the sinews. If the pores' opening and closing lose their proper regulation, cold qi follows and enters, giving rise to severe stooping of the back. When cold sinks into the vessels, it becomes fistula, lingering and lodging in the flesh and interstices. When the qi at the transport points is transformed and becomes attenuated, it is transmitted and becomes excessive fearfulness, and further becomes fright and panic. When the nutritive qi fails to follow its proper course and rebels within the texture of the flesh, this gives rise to welling-abscess and swelling. If the sweat governed by the lung's corporeal soul is not fully discharged, the body becomes weakened and the qi is scorched; the points and transport-holes then close up, and this brings about wind-malaria. Thus wind is the beginning of the hundred diseases. When the body is pure and tranquil, the flesh and interstices remain closed against invasion, so that even in the presence of great winds and severe poisons, one cannot be harmed — this comes from following the sequence of the seasons. Thus when illness lingers long, it is transmitted and transformed into other conditions, and when the upper and lower parts of the body no longer communicate with each other, even a good physician can do nothing. Hence when yang qi accumulates without release, illness leads to death, for the yang qi becomes obstructed; where there is obstruction, one ought to drain it. If proper treatment is not applied swiftly, an unskilled practitioner will only ruin the patient.

Thus, over the course of a single day, the yang qi governs the exterior of the body. At dawn, the human qi is generated; at midday, the yang qi reaches its height; as the sun sets in the west, the yang qi has already become deficient, and the qi gates then close. Therefore, in the evening one should gather in and guard the yang qi, and should not disturb the sinews and bones, nor expose oneself to mist and dew. To act contrary to these three periods of the day will cause the body to become distressed and depleted.

Qibo said: 'Yin stores the essence and rouses it forth repeatedly to respond to yang; yang guards the exterior and secures it firmly. If yin cannot overcome yang, then the pulse flows rapidly and urgently, and when yang qi converges, this results in mania. If yang cannot overcome yin, then the qi of the five viscera contend with one another, and the nine orifices fail to communicate. This is why the sage arranges yin and yang in proper order, so that the sinews and vessels are harmonious, the bones and marrow are firm and solid, and the qi and blood all follow their proper course. When this is so, the interior and exterior are regulated and harmonious, evil qi cannot cause harm, the ears and eyes are sharp and clear, and the qi stands firm as before.'

When wind lodges in the body and overwhelms the qi, the essence is thereby lost, and this is evil injuring the liver. If, in addition, one eats to excess, the sinews and vessels become slack and disordered, and intestinal flux gives rise to hemorrhoids. If one drinks to excess, the qi rebels upward. If one exerts great physical force, the kidney qi is thereby injured, and the great bone of the lower back is thereby damaged. Now, the essential point of yin and yang is this: when yang is dense and secure, it becomes firm. If the two are not in harmony, it is like having spring without autumn, or winter without summer. To bring about their harmony is called the sage's proper measure. Thus if yang is too strong and cannot be kept dense and secure, the yin qi is thereby cut off. When yin is level and balanced and yang is dense and secure, the essence and spirit are well ordered; when yin and yang become separated and severed from each other, the essence qi is thereby exhausted. When the body is affected by exposure to dew and wind, this gives rise to cold and heat disorders.

Thus, if one is injured by wind in spring, the evil qi lingers and lodges within, and this becomes diarrhea with undigested food. If one is injured by summer-heat in summer, in autumn this becomes recurrent malarial fevers. If one is injured by dampness in autumn, qi rebels upward causing cough, and this develops into wilting weakness and reversal. If one is injured by cold in winter, in spring one will certainly develop warm-disease. Thus the qi of the four seasons, in turn, injures the five viscera.

That from which yin essence is generated is rooted in the five flavors; yet the five palaces of yin, the five viscera, can also be injured by the five flavors. Thus, if the flavor sour is consumed to excess, the liver qi becomes overflowing, and the spleen qi is thereby cut off. If the flavor salty is consumed to excess, the qi of the great bones becomes taxed, the muscles are shortened, and the heart qi is repressed. If the flavor sweet is consumed to excess, the heart qi becomes labored and full, the complexion turns black, and the kidney qi loses its balance. If the flavor bitter is consumed to excess, the spleen qi fails to be moistened, and the stomach qi becomes thickened and stagnant. If the flavor pungent is consumed to excess, the sinews and vessels become slack and dissolved, and the essence and spirit are thereby exhausted. Therefore, if one carefully harmonizes the five flavors, the bones will be straight and the sinews supple, the qi and blood will flow freely, and the interstices of the skin will be firm and dense. When this is so, the bone qi will be replete with essence. If one carefully follows the Way according to its proper norms, one will long enjoy the years allotted by Heaven.