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Chapter 30 of 81
黄帝内经·灵枢
Holistic Paraphrase
Editorial note: In the original text as recorded, "膝理/腹理" should be "腠理" (interstices of skin and muscle), "气盼着" should be "气脱者" (qi collapse), "波脱" should be "液脱" (fluid collapse), and "脏疾" should be "胫痠" (soreness of the shin). The following translation and interpretation follow the standard edition of Lingshu·Jue Qi.
The Yellow Emperor asked: I have heard that the human body possesses six things—essence, qi, fluids, liquids, blood, and vessels. I originally thought they were all but "one qi," yet now they are divided into six names, and I do not understand the reasoning behind this. Qi Bo explained one by one: Essence (jing) is the primordial material of life that exists before the body takes form, created by the union of the reproductive essences of the two sexes; qi is developed and dispersed by the Upper Burner (above the diaphragm, governing diffusion and transmission), dispersing the refined essences of the five grains, like mist and dew irrigating and warming the skin, nourishing the entire body, and moistening the hair; fluids (jin) are the subtle sweat that issues forth when the interstices (the spaces between skin and muscle) are opened and released; liquids (ye) are the thick, smooth portion of the refined essences of water and grain, which pour into the bones, making the joints supple and agile in flexion and extension, seeping out to moisten and nourish the brain marrow, and lubricating the skin; blood is formed when the Middle Burner (below the diaphragm, above the navel, governing reception and putrefaction) receives the refined essences of water and grain, extracts their fluids, and transforms them into a red liquid; vessels are what restrain the nutritive qi (the refined qi that travels within the vessels and has nourishing function), keeping it within a defined pathway so that it does not leak outward.
The Yellow Emperor asked again: How can the excess or deficiency, abundance or decline, fullness or emptiness of the brain marrow, and the clarity or turbidity of the blood and vessels of these six qi be known from the outside? Qi Bo said: When essence collapses, there will be deafness; when qi collapses, there will be blurred vision; when fluids collapse, the interstices will open and there will be profuse sweating that does not stop; when liquids collapse, the joints will be unable to flex and extend properly, the complexion will be withered and sallow, the brain marrow will diminish, the shins will be sore and weak, and tinnitus will occur frequently; when blood collapses, the complexion will be pale, withered, and lack luster, and the vessel pathways will be empty and vacuous. These are the external manifestations of the collapse of the six qi.
The Yellow Emperor finally asked: Do the six qi have distinctions of honor and inferiority, or primary and secondary roles? Qi Bo said: Each of the six qi has its own domain that it governs, and their respective priorities, normalcy, and order follow certain patterns. But in the final analysis, the five grains and the stomach are the source from which the six qi are transformed and generated, like the great sea.
One qi with six names; same source, divergent streams
Essence, qi, fluids, liquids, blood, and vessels are not six entirely isolated substances, but rather functional classifications of the body's refined substances at different physiological stages and in different states. Essence leans toward the innate and reproductive; qi leans toward propulsion and warming nourishment; fluids lean toward the thin and dilute, externally discharged as sweat; liquids lean toward the thick and dense, internally pouring into bones and the brain; blood leans toward redness and nourishment; vessels lean toward channel containment. This embodies the medical concept of "qi monism" and the holistic view of "essence, qi, blood, and body fluids."
What is within must manifest externally
This chapter discusses deficiency and damage in terms of "collapse" (tuo), providing the typical external signs of the collapse of the six qi: essence collapse manifests as deafness, qi collapse as blurred vision, fluid collapse as profuse sweating, liquid collapse as joint dysfunction, and blood collapse as pallor and vacuous pulse. This represents early diagnostic thinking in Chinese medicine that judges internal depletion from external orifices, complexion, and pulse, emphasizing the correspondence of interior and exterior.
The stomach as the great sea; the five grains as the source
Although the six qi each have their own location and domain of governance, all depend on the stomach to receive and putrefy water and grains and to transform them into refined essences. This provides the classical basis for "the spleen and stomach as the acquired foundation" and "the source of qi and blood production," also clarifying that dietary water and grains are the fundamental source of continuous replenishment of the vital substances.
The six qi represent an ancient functional classification model of the body's fundamental substances and functions, and cannot be simply equated with modern anatomical structures. For instance, "blood" is relatively close to blood as understood today; "vessels" resembles vascular pathways; "fluids and liquids" roughly corresponds to interstitial fluid, synovial fluid, glandular secretions, and so forth; "qi" is closer to energy metabolism and physiological function; and "essence" encompasses connotations of genetic and reproductive substances. These correspondences are rudimentary and should not be rigorously judged or dismissed by modern microscopic standards.
The "collapse" conditions described in the text—such as fluid collapse resembling dehydration or excessive sweating, blood collapse resembling anemia or reduced blood volume, and liquid collapse with joint dysfunction resembling reduced synovial fluid or malnutrition—have a certain value of empirical observation. However, these correspondences are general and cannot replace modern diagnosis.
"The five grains and the stomach as the great sea" resonates with modern nutritional science, which emphasizes that food, after digestion and absorption, provides the material and energy sources for life. However, the "stomach" in Chinese medicine is a functional concept and is not equivalent to the anatomical stomach.
BuGua note: This content is based on classical Chinese medicine texts and is provided solely for the study and reading of traditional culture. It does not constitute any medical diagnosis, prescription, or treatment advice. If you feel unwell, please seek medical attention promptly.