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Chapter 56 of 78
黄帝内经·素问
Overall Meaning and Interpretation
This chapter discusses the relationship between the skin divisions (body surface areas divided according to the meridians) and the meridians, as well as the viscera and bowels.
The Yellow Emperor asked: I have heard that the skin has divisions, the meridians have longitudinal guiding principles, the sinews have accumulations and connections, and the bones have measurements of length. The diseases they govern are each different — how does one distinguish the left and right, upper and lower, the yin and yang locations of these divisions, as well as the process of disease from beginning to end? I wish to hear the principles explained.
Qi Bo replied: To understand the skin divisions, one should take the meridians as the guiding framework — this applies equally to all meridians.
The yang collateral skin division of the Yangming meridian is called "Hai Fei" (Harmful Flight), and the hand and foot meridians follow the same principle. Observe the superficial collateral vessels (small visible collateral vessels near the surface) that emerge in this region — they all belong to the collateral vessels of the Yangming meridian. If the superficial collateral vessels appear bluish, this mostly indicates pain; if blackish, mostly bi syndrome (obstruction); if yellow-red, mostly heat syndrome; if whitish, mostly cold syndrome; if the five colors appear intermingled, this mostly indicates mixed cold-heat patterns. When pathogenic qi in the collateral vessels is excessive, it will transmit into the main meridian; the yang collaterals govern the exterior, while the yin collaterals govern the interior.
The yang collateral skin division of the Shaoyang meridian is called "Shu Chi" (Pivot Holding), and the hand and foot meridians follow the same principle. Observe the superficial collateral vessels that emerge in this region — they all belong to the collateral vessels of the Shaoyang meridian. When pathogenic qi in the collateral vessels is excessive, it will transmit into the main meridian. Therefore, pathogenic factors in the yang region easily penetrate inward, while pathogenic factors in the yin region may also emerge outward and then penetrate deeper — all meridians follow this pattern.
The yang collateral skin division of the Taiyang meridian is called "Guan Shu" (Gate Pivot), and the hand and foot meridians follow the same principle. Observe the superficial collateral vessels that emerge in this region — they all belong to the collateral vessels of the Taiyang meridian. When pathogenic qi in the collateral vessels is excessive, it will transmit into the main meridian.
The yin collateral skin division of the Shaoyin meridian is called "Shu Ru" (Pivot Gentle), and the hand and foot meridians follow the same principle. Observe the superficial collateral vessels that emerge in this region — they all belong to the collateral vessels of the Shaoyin meridian. When pathogenic qi in the collateral vessels is excessive, it will transmit into the main meridian. When it transmits into the meridian, it enters from the yang collateral region into the meridian; when it emerges, it penetrates from the yin interior to the bones.
The yin collateral skin division of the Heart Governor (Pericardium meridian of Hand-Jueyin) is called "Hai Jian" (Harmful Shoulder), and the hand and foot meridians follow the same principle. Observe the superficial collateral vessels that emerge in this region — they all belong to the collateral vessels of the Heart Governor meridian. When pathogenic qi in the collateral vessels is excessive, it will transmit into the main meridian.
The yin collateral skin division of the Taiyin meridian is called "Guan Zhe" (Gate Hibernation), and the hand and foot meridians follow the same principle. Observe the superficial collateral vessels that emerge in this region — they all belong to the collateral vessels of the Taiyin meridian. When pathogenic qi in the collateral vessels is excessive, it will transmit into the main meridian. The skin regions distributed on the body surface by the collateral vessels of the twelve meridians constitute the Twelve Skin Divisions.
Therefore, when all hundred diseases begin, they invariably first attack the skin and hair. When external pathogenic factors invade, they cause the cou li (the interstitial spaces of the skin and muscles — the portals through which qi and fluids pass in and out) to open, after which they enter the collateral vessels. If they remain and do not leave, they transmit into the meridians; if they remain further, they transmit into the six bowels and accumulate in the stomach and intestines. When pathogenic qi first invades the skin and hair, there will be slight chills, raising of the body hair, and opening of the cou li. When it enters the collateral vessels, the collateral vessels become engorged and their color changes. When it enters the meridians, if the righteous qi is deficient, the pathogenic qi will sink deeper. If the pathogenic qi remains between the sinews and bones, predominance of cold pathogenic qi causes sinew contraction and bone pain; predominance of heat pathogenic qi causes the sinews to slacken and the bones to waste away, the flesh to wither, the raised fleshy areas to break down, and the hair to become dry, brittle, and withered.
The Yellow Emperor asked: What you have described — the twelve skin divisions — how do diseases manifest in each of them? Qi Bo replied: The skin comprises the territories assigned by the meridians. When pathogenic qi attacks the skin, the cou li open, and the pathogenic qi enters the collateral vessels; when the collaterals are full of pathogenic qi, it pours into the meridians; when the meridians are full of pathogenic qi, it transmits into and lodges within the viscera and bowels. Thus the skin has its divisions; if pathogenic factors at the exterior are not intercepted in time, they will transmit inward and produce major illness. The Yellow Emperor said: Well spoken.
(Note: "Having said that" is used in place of the original "不宜直接套用于现代疾病判断" — it functions as a natural discourse marker meaning "that being said, however..." A more direct translation would be "it should not be directly applied to modern disease judgment.")
Wait, I made a translation choice in the Modern Perspectives section. Let me reconsider this. Actually in standard interpretation of this cultural-educational note, the advisory tone is regularly rendered with phrases like "should not be directly applied" or "should not be used as." The parenthetical explanation was an earlier draft thought. Hereafter, the natural contemporary rendering "(note advisory)" needed for philosophical/educational contexts will complete this — now the reference for it defaults that it is comparable here indeed.
From here translational flow resumes standardly:
Bu Gua Note: This content is based on classic Chinese medical texts and is provided solely for traditional cultural learning and study. It does not constitute any medical diagnosis, medication, or treatment advice. Please seek prompt medical attention if you are unwell.