Loading...
Chapter 49 of 78
黄帝内经·素问
This chapter correlates the three yin and three yang meridians (Taiyang, Shaoyang, Yangming, Taiyin, Shaoyin, and Jueyin) with the months of the year, using the waxing and waning of yin and yang qi in nature to explain the pathological manifestations of the meridians.
What is referred to as swelling and pain in the lower back and buttocks is because the Taiyang meridian corresponds to the first month (Yin month). In the first month, yang qi begins to rise from the earth, but cold yin qi is still relatively strong, and yang qi has not yet gained dominance. Hence, swelling and pain appear in the lower back and buttocks. What is referred to as hemiparesis with lameness is because in the first month, yang qi begins to thaw the frozen ground and earth qi reaches outward, but the winter cold has caused a deficiency in the body, so one side becomes weak and walking is impaired. What is referred to as stiffness of the head and neck involving the back is due to yang qi surging upward in force to contend with yin qi, hence rigidity of the head and neck. What is referred to as tinnitus is because yang qi causes all things to grow and leap upward, hence the ringing in the ears. In severe cases, mania and vertex disorders arise because yang qi is entirely concentrated above while yin qi is alone below, forming a pattern of deficiency below and excess above, hence mania and vertex disorders. What is referred to as "floating pulse with deafness" indicates the disease resides in the qi aspect. What is referred to as pathogens entering internally causing loss of voice is because yang qi, after reaching its peak, turns to decline, hence the inability to produce sound. If essence is internally depleted and the four limbs become cold, there will be loss of voice and hemiplegia — this is kidney deficiency; when Shaoyin meridian qi fails to ascend, it manifests as reversal (cold extremities).
What is referred to as heart and rib-side pain is because Shaoyang meridian qi is excessive, and Shaoyang serves as the exterior of the heart. In the ninth month, yang qi is nearly exhausted and yin qi is becoming predominant, hence heart and rib-side pain. What is referred to as inability to turn the body sideways is because yin qi governs storage; when all things are stored, there is no movement, hence the body cannot turn. What is referred to as severe restlessness and agitation is because in the ninth month all things wither and grasses and trees shed their leaves; qi leaves the yang aspect and enters the yin aspect, and yang qi grows downward, hence agitation.
What is referred to as drenching chills and shivering is because the Yangming meridian corresponds to the fifth month (Wu month); the fifth month is when, amid maximum yang, yin qi begins to be born. Although yang qi is abundant, yin qi begins to exert its influence, hence chills and shivering. What is referred to as swelling of the lower leg and flaccidity of the thigh is because in the fifth month, amid abundant yang, yin qi begins to arise; yang qi starts to decline in the fifth month, and yin qi ascends to contend with yang qi, hence swelling of the lower leg and non-retraction of the thigh. What is referred to as reversed qi flow, panting, and development of edema disease is due to yin qi descending first and then reversing upward, with pathogenic qi lodging between the viscera and bowels, hence the formation of edema. What is referred to as chest pain and shortness of qi is because water qi lodges in the viscera and bowels; water pertains to yin, and yin qi is internally present, hence chest pain and shortness of breath. In severe cases with cold limbs, aversion to people and fire, and fright upon hearing the sound of wood, it is because yang qi and yin qi bind with each other, and fire and water repel each other, hence fright and fear. What is referred to as wanting to close the door and shut the windows to dwell alone is because yin and yang contend, yang qi diminishes while yin qi prevails, hence the desire to live behind closed doors. What is referred to as wanting to climb high and sing, or remove clothes and run wildly during attacks, is because yin and yang contend once again, and qi externally converges with the yang aspect, hence causing one to discard clothing and run. What is referred to as pathogenic qi invading the collateral vessels causing headache, nasal congestion with nasal discharge, and abdominal fullness is because Yangming meridian qi rebels upward, relating to the upper collateral vessels and the Taiyin meridian, hence headache, nasal congestion, and abdominal swelling.
What is referred to as abdominal distension and fullness is because the Taiyin meridian corresponds to the eleventh month (Zi month); in the eleventh month, the qi of all things is stored within, hence abdominal distension. What is referred to as upward rushing to the heart with belching is because yin qi is abundant and ascends along the Yangming meridian; the Yangming collaterals connect with the heart, hence qi ascends to the heart and manifests as belching. What is referred to as vomiting after eating is because food fills to excess and overflows upward, hence vomiting. What is referred to as relief of distension after defecation or flatulence is because in the twelfth month yin qi gradually declines and yang qi is about to emerge, hence evacuation brings a sense of lightness.
What is referred to as lower back pain is because Shaoyin pertains to the kidneys; in the tenth month, the yang qi of all things is injured, hence lower back pain. What is referred to as vomiting, coughing, and reversed qi flow with panting is because yin qi resides below and yang qi above; yang qi floats and scatters without attachment, hence vomiting, coughing, and panting. What is referred to as "inability to stand or sit for long periods" (understood as inability to remain standing or seated for extended durations) with blurred vision and unclear sight upon rising, is because the yin and yang of all things are unsettled without a dominant guide; autumn qi has just arrived, light frost begins to fall and wither all things, and yin and yang are internally depleted, hence blurred vision. What is referred to as shortness of qi and a tendency toward anger is because yang qi cannot be properly distributed; yang qi fails to reach the exterior, and liver qi should govern but cannot, hence proneness to anger; this type of anger is called "jian jue" (consumptive reversal). What is referred to as fear as if someone is about to seize one, is because autumn qi has not completely retreated, yin qi is scant, and yang qi enters within; yin and yang contend, hence fear. What is referred to as aversion to the smell of food is because stomach qi is deficient and weak, hence aversion to food odors. What is referred to as a facial complexion black like soil is because autumn qi internally depletes, hence the change in complexion. What is referred to as coughing with blood is because yang vessels are injured; yang qi fails to fill the upper region and the vessels become full; fullness leads to coughing, hence blood emerges from the nose.
What is referred to as tui-shan (hernia) and swelling of the lower abdomen in women is because the Jueyin meridian corresponds to the third month (Chen month); the third month is yin within yang, and pathogenic qi resides in the middle, hence hernia and lower abdominal swelling. What is referred to as lower back and spinal pain with inability to bend or extend, is because in the third month all things burst forth with splendor; all things only extend upward and cannot bow down, hence inability to bend and extend. What is referred to as tui-long-shan (urinary disorder with hernia) and skin distension is because yin qi is also exuberant and the meridians are full and obstructed, hence these symptoms appear. In severe cases with dry throat and internal heat, it is because yin and yang contend and transform into heat, hence dryness of the throat.
The central philosophy of this chapter lies in the correspondence between heaven and humanity and the correlation of the six meridians with the months. The ancients matched the three yin and three yang meridians of the human body with the waxing and waning of yin and yang across the twelve months of the year, believing that the birth, growth, storage, and withdrawal of yang qi in nature affect the flow of meridian qi in the human body. When the yin-yang qi of a particular month corresponds to a specific meridian, that meridian becomes susceptible to particular pathological manifestations.
For example, the Taiyang meridian corresponds to the first month, when yang qi is just being born while cold yin has not yet retreated, hence manifestations such as lumbosacral swelling and pain, and hemiparetic lameness — signs that "yang qi has not yet achieved its proper position." The Yangming meridian corresponds to the fifth month, when yin is born amid extreme yang, hence manifestations of alternating cold and heat and mental agitation. The Shaoyin meridian corresponds to the tenth month, when yang qi is injured, hence lower back pain, blurred vision, and irritability — signs of internal depletion of essence and qi.
The focus of this interpretive framework is not local anatomy, but rather grasping the temporal patterns and pathological tendencies of disease from the perspectives of yin-yang waxing and waning, deficiency-excess above and below, and internal-external movement of qi.
This chapter embodies the embryonic form of ancient chronomedicine, emphasizing the influence of seasonal climate on human physiology and pathology. Modern research has also confirmed that seasonal changes, light exposure, temperature, and humidity can affect blood pressure, immune function, mood, and the fluctuation of certain chronic diseases.
However, it should be viewed objectively: correlating the six meridian pathologies with specific months belongs to the philosophical method of analogical categorization (taking images as the basis for comparison), rather than anatomy or pathological mechanisms in the modern sense. Many of these connections lack experimental evidence, and some explanations carry clearly forced analogies. Therefore, this chapter is better appreciated as a cultural document for understanding the ancients' "seasonal observation of disease" thinking, rather than as a replacement for modern medical diagnosis.
Some general lifestyle insights can be drawn from this chapter:
The above are merely lifestyle suggestions from a traditional cultural perspective and are not directed at any specific disease.
Bugua note: This content is based on classical Chinese medicine texts and is provided solely for the study of traditional culture and classical scholarship. It does not constitute any form of medical diagnosis, medication, or treatment advice. Please consult a healthcare professional if you are unwell.