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Chapter 40 of 81
黄帝内经·灵枢
Editorial Note: In the original text, the characters "妨伯" "钱而疾之" "其气溶" "足太阳" have been corrected to "岐伯" "浅而疾之" "其气滑" "足太阴" respectively, based on the standard edition of Ling Shu.
Overall Paraphrase
The Yellow Emperor asked: I have heard that the twelve regular meridians correspond to the twelve meridian-waters 🌊 (a metaphorical system in which the ancients compared the meridians to twelve major rivers). These twelve meridian-waters each have different colors, and their clarity and turbidity also differ. But if human blood and qi were all in a single uniform state, how could they correspond to this?
Qi Bo replied: If human blood and qi could truly be completely uniform, then the world would be perfectly uniform as well—how could there be any disorder then?
The Yellow Emperor said: I am asking about a single person, not about the multitudes of the world.
Qi Bo said: Even within a single person's body there may be rebellious and chaotic qi, just as among the multitudes of the world there may be rebellious and chaotic people. The principle is the same in both cases.
The Yellow Emperor said: Please explain the clarity and turbidity of the qi within the human body.
Qi Bo said: The qi transformed from ingested food and drink tends to be turbid💨, while the qi transformed from the clean qi taken in through respiration tends to be clear. The clear qi is distributed to the yin aspects, while the turbid qi is distributed to the yang aspects. Within the turbid, there is contained some clear, which rises upward and exits through the throat; within the clear, there is contained some turbid, which descends downward. When clear and turbid interfere with each other, this is called chaotic qi.
The Yellow Emperor asked: The qi of the yin meridians is clear and that of the yang meridians is turbid, yet within the turbid there is some clear and within the clear there is some turbid. How should one distinguish the clear from the turbid?
Qi Bo said: The general distinction of qi is this: the clear is transported upward to the lungs, while the turbid descends into the stomach. The clear portion in the stomach exits upward through the mouth; the turbid portion in the lungs descends into the meridians and accumulates internally at the Sea of Qi (qihai, the gathering place of qi within the chest).
The Yellow Emperor asked: The qi of all the yang meridians tends to be turbid—which yang meridian carries the heaviest turbidity?
Qi Bo said: The Hand Taiyang Small Intestine Meridian alone receives the turbid qi of the yang meridians, while the Hand Taiyin Lung Meridian alone receives the clear qi of the yin meridians. Its clear portion ascends to the orifices of the head and face, while its turbid portion descends through the various meridians. The qi of all the yin meridians tends to be clear, yet the Foot Taiyin Spleen Meridian alone receives the turbid qi of the yin meridians.
The Yellow Emperor asked: Then how should one treat or regulate this?
Qi Bo said: The qi of the clear is slippery and swift, while the qi of the turbid is rough and astringent—this is the normal state of qi. Therefore, when needling the yin meridians, one should insert deeply and retain the needle; when needling the yang meridians, one should insert shallowly and withdraw the needle quickly; when clear and turbid interfere with each other, one should select the appropriate number and frequency of acupuncture treatments according to the specific circumstances to regulate the condition.
This chapter discusses the classification of qi as clear or turbid within the human body and its relationship with the meridians and viscera. The core ideas can be summarized as follows:
Clear and turbid share the same origin but diverge in pathways
The qi of the human body has both clear and turbid aspects—it is not in a single uniform state. The clear qi originates from the natural qi taken in through breathing, while the turbid qi originates from ingested food and drink. The clear tends toward yin, toward the interior, and toward the upper region; the turbid tends toward yang, toward the exterior, and toward the lower region. However, this correspondence is relative, not absolute.
Clear and turbid contain each other, and ascent and descent are interdependent
The text states: "Within the turbid, there is contained some clear, which rises upward and exits through the throat; within the clear, there is contained some turbid, which descends" and "the clear portion in the stomach exits upward through the mouth; the turbid portion in the lungs descends into the meridians," demonstrating that within clarity there is turbidity and within turbidity there is clarity, with an interconnected dynamic of ascent, descent, entry, and exit functioning between the upper and lower, interior and exterior. This reflects the TCM concept of qi transformation as "always in motion without cessation," rather than a fixed classification of substances.
Interference between clear and turbid results in chaotic qi
In their normal state, clear and turbid should each follow their own pathways. When they interfere with one another and their movement becomes disordered, this constitutes "chaotic qi." This is a high-level conceptual summary of qi movement disorder and is an early prototype of the later theory of "qi-mechanism dysregulation."
Acupuncture follows the natural tendency and guides accordingly
Qi Bo states that the qi of the clear is slippery while that of the turbid is astringent; therefore, needling yin meridians should be deep with retention, while needling yang meridians should be shallow with quick withdrawal. This is not merely a technical prescription, but rather an approach of following and regulating based on distinctions in the slipperiness or astringency of qi movement and the depth or shallowness of yin and yang.
Clear and turbid may serve metaphorically, but should not be equated directly
In modern physiology, the human body continuously performs gas exchange, nutrient absorption, and metabolic waste excretion. The TCM phrase "those who receive from food are turbid" may be correlated to substances produced through digestion and absorption, while "those who receive from qi are clear" may be correlated to oxygen taken in through respiration. However, these are only functional-level analogies and should not lead us to directly equate TCM's "clear and turbid" with oxygen, carbon dioxide, or any specific physical substance.
The twelve meridian-waters are an analogical model
The correspondence of the twelve meridians to twelve rivers is an explanatory device derived from the ancient "heaven-human correspondence" worldview. It carries cultural background and theoretical value, but is not empirically grounded in anatomy or fluid dynamics. We should read it as a model for understanding qi movement rather than as a scientific description.
Depth of needling and duration of retention lack uniform modern explanation
Needling depth, needle retention time, and the level of stimulated tissue or density of nerve endings may be related factors, but the underlying mechanisms remain incompletely understood, and it would be inappropriate to directly apply ancient needling principles as modern clinical operational standards.
Clear-turbid interference and internal environment homeostasis
"Chaotic qi" can inspire us to understand imbalances in body states, but it is a philosophical generalization and cannot replace modern medicine's diagnosis and treatment of specific diseases.
Practice breath regulation to support the ascent of clear and descent of turbid
Engaging in gentle practices such as deep breathing, Baduanjin (Eight Section Brocade), or Tai Chi can help smooth qi movement and improve the gathering within the chest and the dynamics of ascent, descent, entry, and exit. These serve as general wellness practices.
Eat with moderation to avoid accumulation of turbidity
Maintaining a light diet and avoiding excessive rich or fatty foods can help reduce excessive stagnation of "grain-derived turbidity" and keep the body feeling clear and refreshed.
Maintain a regular schedule that follows day and night rhythms
Waking and being active in the early morning supports the ascent of clear yang; resting at night at an appropriate time helps turbid yin descend. Regular living habits allow clear and turbid to remain in their proper places.
Maintain emotional steadiness to prevent qi movement disruption
Intense emotional fluctuations can easily disturb qi movement, causing clear and turbid to interfere. Keeping a calm and balanced state of mind is an important aspect of daily care for qi and blood.
The wellness insights above are general health recommendations and do not target any specific disease, nor do they constitute therapeutic guidance.
This content is based on classical texts of Traditional Chinese Medicine and is provided for the study and appreciation of traditional cultural heritage. It does not constitute any medical diagnosis, prescription, or treatment advice. Please consult a qualified healthcare provider if you experience any discomfort.