素问：经络论篇第五十七 - 黄帝内经·素问

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Suwen: Treatise on Collaterals, Chapter Fifty-Seven

Overall Paraphrase

The Yellow Emperor asked: When collaterals are visible on the body surface, they display five different colors—blue-green, yellow, red, white, and black, each varying from the others. What is the reason for this?

Qi Bo replied: The primary channels (the main trunks through which qi and blood circulate in the body) each have their fixed colors, whereas the collaterals (the fine branches arising from the primary channels, distributed throughout the body surface) have no fixed colors and are subject to change.

The Yellow Emperor asked: What are the fixed colors of the primary channels?

Qi Bo answered: The five viscera correspond to the five colors—the heart corresponds to red, the lungs to white, the liver to blue-green, the spleen to yellow, and the kidneys to black. These colors are likewise reflected on their respective primary channels. 🌿

The Yellow Emperor further asked: The collaterals also have yin and yang aspects. Do they likewise correspond in color to the primary channels they belong to?

Qi Bo said: The yin collaterals (collaterals distributed in the deep interior of the body, belonging to yin) match the colors of their respective primary channels. The yang collaterals (collaterals distributed in the shallow layers of the body surface, belonging to yang), however, have colors that are changeable and unfixed, shifting with the succession of the four seasons (spring, summer, autumn, and winter).

Specifically: When cold qi predominates, the movement of qi and blood becomes congested and stagnant (coagulated and blocked), and the yang collaterals manifest a blue-black color. When heat qi predominates, the movement of qi and blood becomes smooth and moist (flowing freely and abundantly), and the yang collaterals manifest a yellow-red color. These are all normal color changes and represent conditions free from disease. If all five colors appear simultaneously on the superficial collaterals, this indicates that cold and heat are intermingled within the body—a sign of pathology.

The Yellow Emperor said: Well spoken.

🧠 Deep Understanding

Core Principles 💡

The central academic significance of this chapter lies in inferring the state of qi and blood and the nature of cold and heat within the body from color changes in the collaterals, embodying the diagnostic approach of Traditional Chinese Medicine known as "examining the external to infer the internal" (observing external manifestations on the body surface to deduce the condition of the viscera, qi, and blood within).

The specific logic of the principles is as follows:

The correspondence between viscera, color, and channels: Each of the five viscera has its corresponding color (heart-red, lungs-white, liver-blue-green, spleen-yellow, kidneys-black), and the primary channels, as passages connecting the viscera to the body surface, match the colors of the viscera to which they pertain. This represents the extension of the five elements—five viscera—five colors system onto the level of the channels and collaterals.
The distinction between yin and yang collaterals: Yin collaterals are located in the deep regions of the body, and their colors are relatively stable, remaining consistent with their respective primary channels. Yang collaterals float on the body surface and are directly influenced by the external environment and the state of qi and blood; therefore, their colors lack a fixed pattern and change according to the seasonal climatic variations and the predominance of cold or heat within the body.
The pathological association between cold/heat and coloration: This is the most essential medical principle of the entire chapter—cold causes congealing and stagnation, manifesting as blue-black; heat causes moistening and lubrication, manifesting as yellow-red. Cold is contractive and congealing in nature, causing qi and blood to move sluggishly; when qi and blood become stagnant in the collaterals, a blue-black color appears. Heat is expansive and stimulating in nature, causing qi and blood to move rapidly and fill abundantly; when qi and blood are profuse and flowing smoothly in the collaterals, a yellow-red color appears. This observation provided a theoretical foundation for later generations to distinguish cold and heat through inspection diagnosis.
The appearance of all five colors indicates disease: When the five colors simultaneously appear on the superficial collaterals, it signifies that cold and heat pathogens are intermingled and that qi and blood are disordered—a pathological manifestation. This embodies Traditional Chinese Medicine's discernment between the "normal" (constant) and the "abnormal" (variable)—single seasonal color changes are normal, whereas complex multi-color presentations indicate disease.

Modern Perspectives 🌟

From a modern medical standpoint, the changes in collateral coloration discussed in this chapter correspond considerably to the state of superficial microcirculation:

Under cold environmental conditions, cutaneous blood vessels constrict and blood flow slows, causing superficial veins to show a bluish-purple hue—highly consistent with the ancient description that "excess cold causes congealing and stagnation, and stagnation manifests as blue-black." 🩺
Under warm conditions, cutaneous blood vessels dilate and blood flow accelerates with increased volume, causing the superficial collaterals to appear flushed or yellow-red—likewise consistent with the statement that "excess heat causes moistening and lubrication, and lubrication manifests as yellow-red."

This demonstrates that the correlations between superficial coloration and cold/heat, accumulated through long-term observation by ancient practitioners, have a physiological basis that can be verified at the level of microcirculation.

However, it must be candidly noted that the mechanical correspondences of the five viscera—five colors—primary channels (heart-red, lungs-white, liver-blue-green, spleen-yellow, kidneys-black) are deductions derived from the ancient five-element categorization system. In modern anatomy, there is no phenomenon whereby the colors of internal organs are directly mapped onto the channel system. This portion should be understood as a symbolic theoretical model rather than a literal anatomical description. Its value lies in providing a systematic framework for observation and categorization, yet its specific correspondences lack empirical support in modern science.

Furthermore, the statement that "the appearance of all five colors indicates cold and heat" is relatively simplistic. Using superficial collateral coloration alone to diagnose the intermingling of cold and heat would, in modern clinical practice, require integration with multidimensional information such as body temperature, complete blood counts, and medical history. It should not serve as a standalone diagnostic criterion.

Health Insights ⚡

The insights this chapter offers for daily life center on observing one's own state and adapting to cold and warm variations:

Pay attention to daily changes in superficial coloration: When the body is healthy, changes in collateral color with the seasons and temperature are normal. If abnormal multi-color presentations or persistently blue-black or murky appearances are noted, one should respond rationally by seeking evaluation from a professional physician rather than making self-diagnoses. 🌿
Keep warm and guard against qi and blood stagnation: The ancients observed that cold causes qi and blood to congeal and stagnate, and collaterals to appear blue-black. This reminds us to stay warm in daily life, especially during cold seasons, avoiding prolonged exposure to cold, to help maintain the smooth circulation of qi and blood.
Engage in moderate physical activity to promote circulation: Appropriate bodily activity helps maintain the smooth flow of qi and blood, avoiding the stagnation that results from prolonged sitting or lying. This aligns with the modern understanding that "regular exercise promotes blood circulation." 💨
Align with the four seasons and accept normal bodily changes: There is no need for excessive concern over seasonal changes in the coloration of superficial collaterals—these are normal manifestations of the body adapting to nature.

📚 Related Knowledge

Related Concepts:
- The Fifteen Collaterals: The human body has fifteen major collaterals that communicate between exterior and interior channels. The "yin collaterals" and "yang collaterals" discussed in this chapter represent a further distinction built upon this system.
- Inspection Diagnosis: The foremost of the four diagnostic methods in Traditional Chinese Medicine (inspection, auscultation-olfaction, inquiry, and palpation), which infers internal health conditions by observing the coloration and morphology of the body surface. This chapter is one of the theoretical origins of "inspecting collateral coloration" within inspection diagnosis.
- The Five Colors and Indicated Conditions: Blue-green indicates cold/stagnation/pain, red indicates heat, yellow indicates dampness/deficiency, white indicates deficiency/cold, and black indicates kidney deficiency/fluid retention/blood stasis—later diagnostic scholarship systematized these associations further based on this chapter.
- The Qi of the Four Seasons: The cyclical rhythms of spring warmth, summer heat, autumn coolness, and winter cold directly affect the movement of qi and blood in the human body. The phenomenon of yang collateral coloration changing with the four seasons is precisely an expression of this principle.
Further Reading:
- Suwen, Treatise on the Skin Sections, Chapter Fifty-Six: Discusses the distribution zones of the twelve primary channels on the skin and the relationship between color changes and disease.
- Suwen, Treatise on the Generation of the Five Viscera, Chapter Ten: Details the correspondences among the five viscera, five colors, five tissues, and five pulses, which mutually corroborate this chapter.
- Lingshu, Primary Channels, Chapter Ten: Systematically discusses the courses and pathological manifestations of the primary channels, including the passage "in all examination of the collaterals, if the vessel color is blue-green, there is cold and pain; if red, there is heat," which can be studied alongside this chapter.
- Lingshu, On Examining the Cubit and Determining Disease, Chapter Seventy-Four: Further discusses specific methods of diagnosing disease through color inspection.

This content is based on classical texts of Traditional Chinese Medicine and is provided solely for the study and appreciation of traditional culture. It does not constitute any medical diagnosis, medication, or treatment recommendation. If you feel unwell, please seek medical attention promptly.

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