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Chapter 62 of 81
黄帝内经·灵枢
The Yellow Emperor asked: The human body has twelve main channels—why is it that only the Hand Taiyang Channel, the Foot Yangming Channel, and the Foot Shaoyin Channel exhibit continuous palpable pulsations on the body surface?
Qi Bo replied: The pulsation of the Foot Yangming Channel is rooted in the Stomach. 🌿 The Stomach is the sea (ultimate source) of nourishment for the five viscera and six bowels. The clear qi (essential qi derived from water and grain) transformed by the Stomach flows upward to the Lung. The Lung qi travels along the Hand Taiyin Channel, and its rhythm of movement is synchronized with respiration—for each exhalation, the pulse beats twice; for each inhalation, the pulse also beats twice. As breathing never ceases, so the pulse never stops beating.
The Yellow Emperor further asked: When qi passes through Cunkou (the radial artery pulsation point at the wrist), why is it so forceful when it surges upward, yet so faint and subtle when it sinks downward? Through which pathway does it travel back and forth? I cannot grasp the principle behind this.
Qi Bo replied: When qi departs from the five viscera, it is sudden and rapid like the release of a crossbow, swift and forceful like water pouring over a dike. After it surges upward to reach the Yuji (the thenar eminence of the palm), its force begins to diminish; the residual qi, having dispersed, then turns back in reverse, which is why the pulsation is weak on the return.
The Yellow Emperor asked: What is the cause of the pulsation of the Foot Yangming Channel?
Qi Bo replied: Stomach qi flows upward to the Lung. Among it, the swift and fierce portion (the strong, rapid component) surges upward to the head, travels along the throat, enters the orifices (the openings of the head and face), follows the ocular system (the tissue connecting the posterior eye to the brain) to enter and connect with the brain, then emerges from the Hangsang (nasopharynx), descends past Keyiren (near ST-7 Shangguan), follows the Yache (mandible region), joins with the Foot Yangming Channel, and descends further to merge with Renying (the carotid pulsation point). This is the pathway by which stomach qi sends a branch toward the Yangming Channel. Therefore, whether at the upper Renying or the lower Cunkou, their pulsations are coordinated and consistent. Thus, if the yang channel is diseased yet the yang pulse becomes smaller, this is a counter pattern; if the yin channel is diseased yet the yin pulse becomes larger, this is also a counter pattern. If both yin and yang pulses are calm and only one location moves independently, like measuring an incline with a rope, this indicates illness.
The Yellow Emperor asked: What is the cause of the pulsation of the Foot Shaoyin Channel?
Qi Bo replied: The Chong Channel (Penetrating Vessel) is the sea of the twelve channels (the convergence point of qi and blood of all channels). Together with the major collateral of the Foot Shaoyin Channel, it originates below the Kidney, emerges from the Qijie (inguinal region), descends along the medial aspect of the thigh, obliquely enters the popliteal fossa (behind the knee), then follows the medial aspect of the tibia, running parallel with the Foot Shaoyin Channel, descending posterior to the medial malleolus (inner ankle) and entering the sole of the foot. Its branch vessel runs obliquely from the ankle, emerges on the dorsum of the foot, enters between the great toe and second toe, and infuses into the various collateral vessels to warm and nourish the foot. This is the reason the Chong Channel has constant pulsation.
The Yellow Emperor further asked: The Nutritive qi (ying qi) and Defensive qi (wei qi) circulate, connecting above and below, like an unbroken ring without end. Now if someone suddenly encounters pathogenic qi, or experiences severe cold, causing the hands and feet to become limp and powerless, and the pathways of yin and yang in the channels, as well as the meeting points of mutual transfer, lose their normal order—then through which route does qi return?
Qi Bo replied: The four extremities are the meeting points of the yin and yang channels and the location of the major collaterals of qi. The Four Streets (the four qi thoroughfares: head, chest, abdomen, and shins) are the great pathways through which qi travels. Therefore, even if the small collateral vessels are blocked, the major channels can still allow passage; even though the four extremities are limp and non-functional, qi can still converge through the Four Streets, mutually transferring, and continue circulating like an unbroken ring.
The Yellow Emperor said: Well spoken! This is what is meant by "like a ring without ends" — not knowing where it begins, ending and then starting anew. This is precisely the principle.
The central theme of this chapter is the mechanism of channel pulsation and the pathways of qi-blood circulation, unfolding across three levels:
First Level: The linkage mechanism of stomach qi—lung qi—respiration—pulse. Qi Bo traces the fundamental driving force of pulse beating back to the Stomach. The Stomach transforms water and grain into essential subtle substances, which ascend to the Lung. The Lung governs qi and regulates respiration, and when lung qi travels along the channels, it follows the rhythm of breathing, establishing the pattern of "two pulse beats per exhalation, two per inhalation." This constitutes the complete chain of "Stomach → Lung → Pulse → Respiration," demonstrating that the pulse is not merely a reflection of heart beating, but within the framework of Chinese medical theory, it is an expression of the prosperity or decline of stomach qi—this is also the origin of the later doctrine that "the pulse takes stomach qi as its root."
Second Level: The relationship between the Chong Channel and Foot Shaoyin pulsation. The Chong Channel is called the "sea of the twelve channels." It originates below the Kidney, and its trajectory largely overlaps with the Foot Shaoyin Channel, particularly along the descent down the medial aspect of the lower limb. This explains why a continuous pulsation can be palpated posterior to the medial malleolus (near KI-3 Taixi)—it is essentially the pathway of the Chong Channel. Here, the Chong Channel's function is to "warm the foot and lower leg," infusing qi and blood into the collateral vessels of the foot.
Third Level: The Four Streets theory and the safeguard mechanism of circulation. When the extremities encounter cold that blocks the collaterals and impedes qi-blood flow, Qi Bo proposes the concept of the Four Streets (head, chest, abdomen, and shins). The Four Streets are major conduits for qi movement, equivalent to "main roads," while the collaterals of the extremities are equivalent to "branch roads." If branch roads are blocked, the main roads remain passable, allowing qi and blood to reconverge through the Four Streets and maintain the circulation of "like a ring without ends." This reflects traditional Chinese medicine's profound understanding of the redundancy and compensatory capacity of the qi-blood circulatory system.
Modern view of "the Stomach as the sea of the five viscera and six bowels": From a modern physiological standpoint, the digestive system is indeed the fundamental source of the body's energy supply. Nutrients such as glucose, amino acids, and fatty acids are absorbed through digestion and transported throughout the body via the bloodstream, which corresponds functionally with the description of "stomach qi ascending to the Lung, the Lung coursing to all channels." While the ancients lacked precise knowledge of blood circulation, they grasped the core logic of "digestion and absorption → energy transport → whole-body nourishment."
The observational value of "two pulse beats per breath": This record indicates that over two thousand years ago, ancient observers had already noticed a relatively stable ratio between respiration and heart rate (approximately four pulse beats per respiratory cycle, i.e., a respiration-to-heartbeat ratio of about 1:4). Modern physiology confirms that this respiratory sinus arrhythmia (heart rate increasing during inspiration and decreasing during expiration) is a normal phenomenon—the ancients' observation was accurate.
Systems thinking in the "Four Streets" theory: The concept of the Four Streets shares remarkable similarities with the modern medical concept of collateral circulation. When one pathway is blocked, the body compensates through alternative routes to maintain overall circulation. Of course, the ancients constructed this based on channel theory rather than vascular anatomy, but their systems-level compensatory thinking deserves recognition.
Historical limitations: The ancients attributed the three pulsation sites (Hand Taiyang, Foot Yangming, and Foot Shaoyin) to theoretical concepts such as stomach qi and the Chong Channel, rather than explaining them from the perspective of cardiac pumping and arterial anatomy. The pulsation at the ankle (corresponding to Foot Shaoyin) represents the posterior tibial artery; the pulsation at the neck corresponds to the common carotid artery; the pulsation at the wrist corresponds to the radial artery—all of these are superficial arterial locations, rather than the "Chong Channel" or "stomach qi" themselves. The ancients' understanding of blood circulation pathways ("qi departing from the viscera, sudden like the release of a crossbow") was an imaginative construct that does not align with actual hemodynamics.
Protecting stomach qi is fundamental to health cultivation 💡: Since "the Stomach is the sea of the five viscera and six bowels," one should practice moderation in diet—neither excessive hunger nor overeating, avoiding binge eating—so that protecting digestive function preserves the source of qi and blood production for the entire body. This constitutes general dietary principles applicable to all.
The relationship between respiration and qi-blood: The ancients emphasized that "qi moves with breath," suggesting that stable respiratory rhythm significantly impacts qi-blood circulation. In daily life, one may cultivate even, deep breathing patterns and avoid rapid, shallow breathing—a general recommendation for breath regulation.
Keep extremities warm 🔥: The text mentions "encountering severe cold, the hands and feet become limp," showing that the ancients recognized the obstruction cold pathogens create to qi-blood movement in the extremities. In daily life, maintaining warmth of hands and feet, especially avoiding prolonged exposure to low temperatures during cold seasons, helps preserve smooth qi-blood circulation—general protective guidance.
Moderate activity promotes qi-blood flow 💨: The Four Streets theory tells us that even when peripheral circulation is compromised, the body maintains compensatory pathways. Moderate exercise can activate qi-blood movement and maintain channel patency—general lifestyle advice.
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 medical diagnosis, medication, or treatment advice. If you feel unwell, please seek medical attention promptly.