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Chapter 8 of 81
黄帝内经·灵枢
Overall Paraphrase
Huangdi asked Qi Bo: In the general rules of acupuncture treatment, one must first take "Shen" (the controller of life activities and spiritual consciousness) as the root. Blood, vessels, nutritive qi, qi, essence, and spirit are the life substances and functions stored by the five viscera. If they become excessively dispersed or leave the viscera in which they are stored, then essence-qi will be lost, the ethereal and corporeal souls will fly away and scatter, decision-making will become confused, and wisdom will depart from the body. What causes this? Is it a fault of Heaven above, or a fault of humans themselves? What are the meanings of De, Qi, Sheng, Jing, Shen, Hun, Po, Xin, Yi, Zhi, Si, Lü, and Zhi? Please explain the principles involved.
Qi Bo replied: What Heaven bestows upon us is "De" (the vital principle of life received at birth); what Earth bestows upon us is "Qi" 🌬️ (the material energy constituting life). Heavenly De flows downward, earthly Qi presses upward, and when the two combine, life comes into existence. Therefore, the fundamental substance at the beginning of life is called "Jing" (Essence); when the two subtle aspects of yin and yang combine to produce life activity and the spiritual controller, this is called "Shen" (Spirit); the perceptual and motor functions that follow the Spirit are called "Hun" (Ethereal Soul); those that enter and exit together with the Essence and govern physiological instincts are called "Po" (Corporeal Soul); that which is capable of engaging with and recognizing external things is called "Xin" (Heart-Mind); the Heart's recollections of external things are called "Yi" (Intention); when an intention becomes established and forms a clear direction, it is called "Zhi" (Will); the repeated contemplation and modification undertaken to realize the Will is called "Si" (Thought); the extension of thinking toward long-range deliberation is called "Lü" (Forethought); and the ability to handle affairs appropriately through deep forethought is called "Zhi" (Wisdom).
Therefore, the sage's approach to nurturing life invariably involves conforming to the four seasons, adapting to cold and heat, harmonizing joy and anger, stabilizing daily routines, moderating yin and yang, and balancing hardness and softness. In this way, pathogenic influences cannot easily invade, and one may enjoy health and longevity.
Thus, fear, wariness, and excessive brooding harm the "Shen"; when the Shen is harmed, one becomes fearful, and seminal fluid leaks away without cease. Excessive grief agitates the viscera, causing essence-qi to wither and lose the vitality of life. Excessive joy causes the spirit-qi to scatter and fail to be stored within. Excessive worry causes qi to become obstructed and unable to move. Great anger causes one's spirit and consciousness to become confused and lose self-control. Excessive fear causes spirit-qi to stir, scatter, and fail to be reined in.
Speaking specifically of the five viscera:
When fear cannot be resolved, it harms the Jing; when the Jing is harmed, there is aching and soreness of the bones and joints, wilting and reversal cold of the four limbs, and frequent seminal emission or spermatorrhea. Therefore, the five viscera store essence-qi and must not be harmed; when harmed, they lose their capacity to hold, resulting in yin vacuity. When yin is vacuous, it cannot transform qi, and without qi, death ensues. Thus, those who practice acupuncture must observe the patient's bearing to understand the preservation or loss, existence or absence of the spirit, ethereal soul, corporeal soul, intention, and will; if the Shen, Hun, Po, Yi, and Zhi stored in the five viscera have already been damaged, one cannot rely on acupuncture treatment alone.
The Liver stores the blood, and the blood is the abode of the Hun. When liver-qi is vacuous, one is prone to fear; when liver-qi is replete, one is prone to anger. The Spleen stores the nutritive qi, and the nutritive qi is the abode of the Yi. When spleen-qi is vacuous, the four limbs cannot move properly and the five viscera become unsettled; when the spleen is replete, there is abdominal distension and difficulty with urination and defecation. The Heart stores the vessels, and the vessels are the abode of the Shen. When heart-qi is vacuous, one is prone to grief; when heart-qi is replete, one laughs without stopping. The Lungs store qi, and qi is the abode of the Po. When lung-qi is vacuous, the nose is blocked and breathing is short; when lung-qi is replete, there is wheezing with sound, chest fullness, and breathing with the face upturned. The Kidneys store the essence, and the essence is the abode of the Zhi. When kidney-qi is vacuous, there is reversal cold of the four limbs; when kidney-qi is replete, there is abdominal distension and the five viscera become unsettled. One must carefully examine the pathological manifestations of the five viscera to understand the vacuity or repletion of visceral qi and carefully regulate and treat accordingly.
⚠️ The original text contains a few transcription errors from hand-copying, such as "利" read as "刺" and "怀" read as "悴," etc. The translation has been corrected according to the standard received edition.
The core of this passage is the life view of "unity of form and spirit" and the pathogenic model of "five emotions harming the viscera."
Shen as the Root of Life: The title "Benshen" (Rooting in Spirit) treats "Shen" as the root of life activity and acupuncture treatment. The five viscera not only store blood, vessels, nutritive qi, qi, and essence, but each also stores one aspect of spirit: the Liver stores Hun, the Heart stores Shen, the Spleen stores Yi, the Lungs store Po, and the Kidneys store Zhi. Material substance and spiritual activity are inseparable.
The Hierarchy of Mental Activity: The text presents a continuous spectrum from the innate to the acquired—
Jing → Shen → Hun/Po → Xin → Yi → Zhi → Si → Lü → Zhi
This is both a classification of psychological processes and a distinctive framework through which Chinese medicine understands "cognitive activity." It progresses layer by layer from instinctive Hun and Po, to perceptual "Heart-Mind," to recollective "Intention," to decisive "Will," to contemplative "Thought," to farsighted "Forethought," to discerning, executive "Wisdom."
Emotional Injury to the Five Viscera: Excessive joy, anger, worry, brooding, grief, fear, and fright can reversely harm the viscera in which they are stored. The text's pairings—"Heart harmed by fear and brooding harms Shen," "Spleen harmed by worry and grief harms Yi," "Liver harmed by grief and sorrow harms Hun," "Lungs harmed by joy and happiness harms Po," "Kidneys harmed by great anger harms Zhi"—form a complete emotion–viscera–spirit correspondence. The claims about death occurring in winter/spring/autumn/summer are extrapolations made according to five-phase generation and control combined with the four seasons, reflecting the holistic view of "correspondence between Heaven and humanity," but they belong to ancient theoretical modeling.
Examining the Spirit First: The passage ends by emphasizing that "those who use acupuncture must observe the patient's bearing to understand the preservation or loss, existence or absence of the spirit, ethereal soul, corporeal soul, intention, and will." This shows that the ancients already recognized the need to assess the state of spiritual preservation before treatment, stating that "when the five aspects have already been harmed, acupuncture cannot treat it"—a cautious approach to severe spiritual exhaustion or systemic collapse.
An Early Prototype of Psychosomatic Medicine: This passage directly links psychological states to visceral functions, resonating with modern psychosomatic medicine's understanding of the interactions among "emotion–autonomic nervous system–endocrine–immune" systems. Chronic anxiety, depression, fear, and anger can indeed affect the cardiovascular, digestive, and immune systems through stress mechanisms.
A Classical Classification of Cognitive Processes: The text's descriptions of "Intention, Will, Thought, Forethought, and Wisdom," while less precise than modern cognitive psychology, can already distinguish different mental functions such as memory, volition, thinking, foresight, and decision-making. Its hierarchical structure remains illuminating.
Viewing Five-Phase Extrapolations Objectively: Statements such as "death occurs in winter" or "death occurs in spring" are typical expressions of the Neijing era's use of five-phase–five-viscera–four-seasons theory to explain disease prognosis. They are not modern death predictions and should not be used directly as clinical judgments. Their value lies in reminding practitioners to consider the influence of emotions and seasons on the body's state, not in specifically predicting a season of death.
The Significance of "Acupuncture Cannot Be Used When Spirit Is Harmed": This can be understood as the ancients recognizing that when mental faculties or systemic qi movement are severely debilitated, a single external treatment modality may be insufficient and require comprehensive regulation. This bears some similarity to modern medicine's multidisciplinary approach to certain terminal or severely mentally disordered patients, though the two should not be equated.
Related Concepts:
Further Reading:
This content is based on classical Chinese medicine texts and is provided solely for traditional cultural study and research. It does not constitute any medical diagnosis, prescription, or treatment advice. If you feel unwell, please seek medical attention promptly.
— Bu Gua