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Chapter 76 of 78
黄帝内经·素问
Overall Paraphrase
This chapter discusses the classification of yin-yang meridians, pulse manifestations, and pathogenesis. At the beginning of early spring, the Yellow Emperor sat quietly observing the eight directions and examining the qi of the eight winds. He asked Lei Gong: In the classification of yin and yang, the circulation of meridians, and the domination of the five viscera, which viscus is most noble? Lei Gong replied: Spring corresponds to jia-yi, its color is green, and internally corresponds to the Liver. The liver governs seventy-two days and is the time when pulse qi holds sway, so he believed the liver was most noble. The Yellow Emperor said: Go and think again about the principles of the upper and lower classics and of yin-yang composure. What you call "most noble" is actually a lower-level view.
After seven days of fasting and purification, Lei Gong again attended upon the Yellow Emperor. The Emperor said: Three Yang (Taiyang channel) is like the main trunk, Two Yang (Yangming channel) is like the sustaining network, One Yang (Shaoyang channel) is like the mobile deployment—through these one can understand the beginning and end of the five viscera. Three Yang governs the exterior, Two Yin (Shaoyin channel) governs the interior, One Yin (Jueyin channel) marks the exhaustion of yin and birth of yang, like the transition from month-end to month-beginning. Together they can rectify and verify the principles of yin and yang. Lei Gong said: I have heard this but have not yet understood.
The Yellow Emperor explained: What is called Three Yang is the Taiyang channel. When its pulse reaches the hand-taiyin at the cunkou position, if it appears wiry and floating but not sunken, one must judge according to proper norms, examine it with focused intention, and cross-reference with yin-yang theory. What is called Two Yang is the Yangming channel. When its pulse reaches the hand-taiyin, if it is wiry and deeply urgent, not drumming against the fingers, and moreover heat arrives, the ancients considered this mostly a critical condition. One Yang is the Shaoyang channel. When its pulse reaches the hand-taiyin, connecting upward with the renying pulse, wiry, tense, and suspended without interruption—this is Shaoyang disease pulse. If a purely yin sign appears, the ancients considered the prognosis poor.
Three Yin is the Taiyin channel. It governs all six channels. Its pulse converges at the taiyin cunkou, deep yet drumming, not floating, with emptiness above disturbing the heart-mind. Two Yin is the Shaoyin channel. Its pulse reaches the lung, its qi returns to the bladder, and externally it connects with the spleen and stomach. One Yin is the Jueyin channel. When it arrives alone, the channel seems to cease, qi floats without drumming, and the pulse is hook-like yet slippery. These six kinds of pulse manifestations are sometimes yin, sometimes yang, intersecting and merging. The channels and collaterals intricately connect the five viscera, conforming to yin-yang transformations. What arrives first is the "host," what arrives later is the "guest."
Lei Gong said: I have exhausted what I know. I have received the tradition of pulse diagnosis and can recite the way of composure, yet I still do not understand the profound meaning of yin-yang male-female dynamics. The Yellow Emperor said: Three Yang is like the father, Two Yang is like the guard, One Yang is like the guiding principle; Three Yin is like the mother, Two Yin is like the female, One Yin is like the solitary envoy.
When Two Yang and One Yin are both diseased, Yangming is the primary disease, but it cannot overcome One Yin. The pulse is soft yet stirring, and the qi of the nine orifices is all sinking and stagnant. When Three Yang and One Yin are both diseased, the Taiyang pulse shows excess, One Yin cannot restrain it, causing internal disturbance to the five viscera and externally manifesting fright and alarm. When Two Yin and Two Yang are both diseased, the illness is in the lung. The Shaoyin pulse is deep, overpowering the lung and harming the spleen, extending externally to the four limbs. When Two Yin and Two Yang intersect and arrive together, the disease is in the kidney, manifesting as verbal abuse, abnormal behavior, and cranial disorders with mania.
When Two Yin and One Yang are both diseased, the illness arises from the kidney. Yin qi wanders as a guest in the cardiac region. The lower orifices lose their defensive containment, becoming blocked and impassable, and the four limbs seem separated and uncoordinated. When One Yin and One Yang alternate with interruptions and fail to continue, yin qi rises to the heart, moving irregularly above and below, entering and exiting without awareness, with dryness of the throat—the disease lies in the spleen-earth. When Two Yang and Three Yin are diseased together, the qi of ultimate yin is all present. Yin does not intersect with yang, yang cannot restrain yin, and yin and yang are both severed. A floating pulse indicates blood conglomeration (xue jia) ; a deep pulse indicates purulent swelling (nong fu). If both yin and yang are vigorous, the disease extends to the lower jiao's yin and yang. Above, it corresponds to the brightness of heaven's seasons; below, to the profundity of earth's geography. By comprehensively assessing, one may determine the period of life or death, in accordance with the beginning of the year and the four seasons.
Lei Gong asked about the "short-term" (critical period). The Yellow Emperor did not answer. Lei Gong asked again. The Emperor said: It is discussed in the classics. Lei Gong requested a detailed explanation. The Emperor said: Diseases of the three winter months, if the nature of the disease accords with yang, and by the first month of spring the pulse shows signs of fatality, the ancients considered danger to occur around the end of spring. In diseases of the three winter months, when the principles and norms have been exhausted, when the willow leaves wither under the killing frost, and in spring both yin and yang are severed, the critical period is in early spring. In diseases of the three spring months, this is called "yang being killed." When yin and yang are both severed, the critical period is at the time when grasses dry. In diseases of the three summer months, ultimate yin lasts no more than ten days. When yin and yang intermingle chaotically, the period is at the time of rising waters. In diseases of the three autumn months, the qi of three yang can all arise, and sometimes recovery occurs without treatment. If yin and yang intersect in disordered fashion, then one cannot stand after sitting, nor sit after standing. When the three yang pulse arrives alone, the period is at the time of stone-water. When the two yin pulse arrives alone, the period is at the time of abundant waters.
The core of this chapter is using the three yin and three yang as the framework to discuss meridians, pulse manifestations, pathogenesis, and four-season prognoses.
The ancient medical principles in this chapter hold systematic classificatory value: it incorporates complex meridians, pulse manifestations, and syndromes into a three-yin-three-yang framework, facilitating clinical analysis and reflecting the highly abstract theoretical thinking of the pre-Qin and Han periods. Descriptions of pulse qualities such as wiry, floating, deep, slippery, and urgent still find correspondences in contemporary pulse diagnosis, though their interpretation relies heavily on individual experience and has limited objective reproducibility.
The "short-term," "signs of fatality," and "period at…" statements at the end of the chapter belong to ancient prognostic reasoning, not modern medical judgment. Statements such as "diseases of the three autumn months, when three yang all arise, recover without treatment" should not be understood as grounds for declining modern medical care in the present day. Modern prognosis of disease should be based on clinical examination and physician assessment. This content should be studied as ancient medical history and theoretical thought, not as practical medical guidance.
This content is based on classic ancient Chinese medical texts and is provided solely for the study and research of traditional culture. It does not constitute any medical diagnosis, medication recommendation, or treatment advice. If you feel unwell, please seek medical attention promptly.