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Chapter 17 of 81
黄帝内经·灵枢
Overall Paraphrase
The Yellow Emperor asked, wishing to hear the principles of "meridian measurement." Qi Bo replied: The six Yang meridians of the hands, running from the hands to the head, each measure five chi in length; the six together total three zhang. The six Yin meridians of the hands, running from the hands to the chest, each measure three chi and five cun; the six together total two zhang and one chi. The six Yang meridians of the feet, running from the feet up to the head, each measure eight chi; the six together total four zhang and eight chi. The six Yin meridians of the feet, running from the feet to the chest, each measure six chi and five cun; the six together total three zhang and nine chi. The Qiao meridians (the channels governing left-right bodily balance and eyelid opening and closing) run from the feet upward to the eyes, each measuring seven chi and five cun; the two together total one zhang and five chi. The Du meridian and the Ren meridian each measure four chi and five cun; the two together total nine chi. The grand total is sixteen zhang and two chi — this is the body's major "great meridian pathway" through which qi circulates.
The meridians form the deep main trunks; branches that diverge horizontally from the meridians are called collaterals; further branches of the collaterals are called minute collaterals. If pathogenic qi is excessive in the minute collaterals with congested blood flow, the ancients held that rapid collateral needling to release blood was appropriate; where pathogenic qi is excessive and replete, draining methods are used; where upright qi is deficient, medicinal tonification may be employed.
The essential qi of the five viscera constantly rises internally to connect with the seven orifices of the head and face. Thus, lung qi communicates with the nose — when lung qi is harmonious, the nose can distinguish fragrance from odor; heart qi communicates with the tongue — when heart qi is harmonious, the tongue can discern the five flavors; liver qi communicates with the eyes — when liver qi is harmonious, the eyes can differentiate the five colors; spleen qi communicates with the mouth — when spleen qi is harmonious, the mouth can distinguish the five grains; kidney qi communicates with the ears — when kidney qi is harmonious, the ears can hear the five notes. When the five viscera are dysfunctional, the seven orifices become blocked; when the six bowels are disharmonious, pathogenic qi may accumulate and form swellings and abscesses.
Therefore, when pathogenic qi resides in the six bowels, the Yang meridians become disharmonious; when the Yang meridians are disharmonious, qi movement becomes stagnant; when qi movement stagnates, Yang qi becomes excessive. When Yang qi is too exuberant, the Yin meridians become impaired; when the Yin meridians are impaired, blood flow stagnates; when blood flow stagnates, Yin qi becomes excessive. When Yin qi is too exuberant, Yang qi cannot circulate to warm and nourish — this is called "closure." When Yang qi is too exuberant, Yin qi cannot circulate to moisten and nourish — this is called "repulsion." When both Yin and Yang are exuberant and cannot nourish each other, this is called "closure-repulsion." When closure-repulsion appears, one often dies before reaching their natural lifespan.
The Yellow Emperor asked: Where does the Qiao meridian begin and where does it end? What qi nourishes and drives its movement? Qi Bo replied: The Qiao meridian is a branch of the Foot Shaoyin meridian. It arises behind the prominent bone (the bony protrusion anterior and inferior to the medial malleolus), ascends above the medial malleolus, continues straight up along the medial thigh into the genital region, then ascends along the interior of the chest into the supraclavicular fossa, emerges anterior to the Renying point, enters the cheek region, and connects to the inner canthus of the eye, where it joins with the Foot Taiyang meridian and the Yang Qiao meridian to ascend together. When the qi of the Yin and Yang Qiao meridians merges and circulates, it can moisten both eyes; when qi fails to nourish them, the eyes cannot close properly.
The Yellow Emperor asked: Why does qi circulate only through the five viscera and not nourish the six bowels? Qi Bo replied: Qi cannot cease moving — it is like flowing water, like the ceaseless motion of the sun and moon. Thus, the Yin meridians nourish the five viscera, and the Yang meridians nourish the six bowels, like a ring without an end, its starting point unknown, ending and beginning again without cease. The overflowing qi, internally, irrigates the viscera and bowels; externally, it moistens the interstitial spaces (the textures and gaps between skin and muscles).
The Yellow Emperor asked: The Qiao meridian has both a Yin Qiao and a Yang Qiao — which one is included in this total meridian measurement? Qi Bo replied: In men, the Yang Qiao is counted as a meridian in the measurement; in women, the Yin Qiao is counted as a meridian; the one counted is considered a meridian, the one not counted is considered a collateral.
Note: The original text contains a few copyist errors; for example, "颁脉" and "缺脉" should follow the standard edition as "跷脉," and "明脉" should be "阴脉." The above paraphrase follows the textual emendations of the standard edition of the Ling Shu.
Establishing a mathematical model of qi-blood circulation through "meridian measurement"
This chapter assigns specific lengths to the twelve primary meridians, the Qiao meridians, and the Du and Ren meridians, totaling sixteen zhang and two chi, designated as the body's "great meridian pathway." This is not anatomical measurement in the modern sense, but rather the ancients' use of numerical reasoning to describe the total length of the pathways through which qi and blood circulate — reflecting a cognitive approach in which "internal structure can be quantified."
The hierarchical structure of meridians—collaterals—minute collaterals
The ancients divided the vascular pathways into three layers: the meridians lie deep as main trunks, horizontally diverging branches form collaterals, and further branches of collaterals form minute collaterals. This closely resembles a tree structure from trunk to branches to twigs, indicating that qi-blood circulation is not a single line but a network system extending from coarse to fine, from deep to superficial.
The five viscera connecting to the seven orifices: a holistic correspondence between internal organs and external sensory openings
Lung—nose, heart—tongue, liver—eyes, spleen—mouth, kidney—ears: these constitute an important part of the "visceral manifestation" theory in Chinese medicine. Here, "connection" does not mean a literal physical tube directly linking organs; rather, it holds that the exuberance or decline of essential qi in the five viscera can be reflected in the corresponding orifices. Therefore, when the seven orifices function abnormally, the ancients did not merely look at the local site but sought causes within the five viscera.
Yin-Yang closure-repulsion: a critical model of systemic imbalance
"Closure" refers to Yin qi being too exuberant, preventing Yang from entering; "repulsion" refers to Yang qi being too exuberant, preventing Yin from exiting. When Yin and Yang mutually repel and fail to communicate, this is called "closure-repulsion." This is an ancient theoretical summary of severe systemic dysfunction and extreme Yin-Yang imbalance, constituting a critical condition. It emphasizes that Yin and Yang are mutually rooted and mutually dependent — neither can be neglected.
The Qiao meridian governs eyelid opening/closing and the merging of Yin-Yang qi
The Yin Qiao and Yang Qiao meet at the inner canthus of the eye, and when their two qi "merge and circulate in return," the eyes can be moistened and open or close properly. From this, the ancients explained the relationship between sleep, wakefulness, eyelid movement, and the Qiao meridian, also attributing abnormal sleep-wake patterns to imbalance of the Yin and Yang Qiao meridians.
Qi circulates in an endless cycle, like a ring without an end
Yin meridians nourish the viscera, Yang meridians nourish the bowels; qi flows like water, moves like the sun and moon in ceaseless circulation. This embodies the Chinese medical view of life as "ceaseless movement," emphasizing that vitality lies in motion, not stasis.
Meridian measurement data has a theoretical-model nature
The figure of sixteen zhang and two chi is a standardized model constructed by physicians of the Warring States and Qin-Han periods, reflecting a mindset of encapsulating the规律 of the human body through numbers. If examined against modern anatomical measurements, it would clearly not correspond; however, as a "theoretical model," it carries the ancients' holistic grasp of qi-blood circulation and should not be simplistically dismissed as backward or nonsensical.
The five viscera connecting to the seven orifices reflects holism, not anatomical pathways
Modern medicine has indeed confirmed that many internal diseases can affect the eyes, ears, nose, tongue, and other sensory organs — metabolic diseases, immune disorders, and neurological conditions may all manifest through the orifices. However, phrases like "the lung opens into the nose" and "the kidney opens into the ear" belong to ancient categorization and empirical generalization, not equivalent to modern anatomical or physiological correspondence. They should be viewed as a window into understanding ancient diagnostic reasoning.
Collateral bloodletting for excess and tonification for deficiency reflect dialectical thinking
"Drain that which is replete; where vacuity is present, administer medicine to supplement" represents early thinking on differentiated treatment of excess and deficiency patterns, consistent with later principles of "excess is drained, deficiency is supplemented." However, the original text's "where replete with blood, rapidly execute it" involves bloodletting procedures — ancient medical practices that should not be self-attempted in modern times; any treatment should be conducted under proper medical supervision.
Closure-repulsion represents a holistic assessment of critical conditions
The ancients already observed that when internal and external, Yin and Yang cannot communicate severely, the condition becomes grave. This parallels the modern understanding of overall deterioration in critical states such as severe infection or multiple organ failure, though "closure-repulsion" is not the equivalent of any specific modern disease name and cannot be directly substituted.
The connection between Qiao meridians and eyelid function/sleep reflects sound observation
The ancients linked eyelid movement, sleep-wake cycles, and the Qiao meridians, showing early recognition of the relationship between the eyelids and the mechanisms controlling arousal and sleep. Modern medicine understands eyelid opening and closing as controlled by the orbicularis oculi and levator palpebrae superioris muscles, innervated by nerves, with sleep regulated by the central nervous system. The two explanatory frameworks differ, yet the phenomena observed are shared.
Align with circadian rhythms and protect the Yin-Yang transition
The Qiao meridian relates to eyelid opening and closing, and the ancients emphasized rising with the sun and resting with its setting. In modern life, avoid staying up late or reversing day and night as much as possible; give the body a stable daily rhythm conducive to overall recovery.
The seven orifices are "windows" into bodily information
Nasal congestion, tinnitus, dry eyes, bitter mouth, abnormal smell or taste sensations — these are not necessarily trivial local issues; they may signal systemic imbalance. If they persist, seek proper medical evaluation rather than self-prescribing "heat-clearing" or "detoxifying" remedies, or simply enduring them indefinitely.
Keep qi and blood flowing; avoid prolonged sitting or lying
Meridian qi circulates "like a ring without end" — life values circulation. Daily moderate walking, stretching, and limb movement can help prevent qi-blood stagnation from prolonged fixed postures. This is general lifestyle advice only and is not targeting any specific disease.
Maintain emotional equilibrium to prevent excessive Yin or Yang
Rage, anxiety, and chronic stress can cause qi stagnation or Yang exuberance; excessive depression and suppression can impede qi movement. Maintaining emotional stability helps harmonize Yin and Yang and reduce the risk of extreme imbalance such as "closure-repulsion."
Associated Concepts
Further Reading
This content is based on classical Chinese medical texts and is provided solely for traditional cultural study and research. It does not constitute any form of medical diagnosis, medication prescription, or treatment advice. If you feel unwell, please seek medical attention promptly.