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Chapter 79 of 81
黄帝内经·灵枢
The Yellow Emperor asked Qi Bo: "The medical classics say that if one is injured by summer heat ☀️, malaria will develop in autumn, and the attacks occur at regular intervals. What is the reason for this?"
Qi Bo replied: The pathogenic qi (disease-causing factor) first invades Fengfu (an acupoint on the midline of the back of the neck), then travels downward along the spine. The Wei qi (defensive yang qi that circulates on the body surface, providing defense and nourishment) completes one full circuit of the body day and night, always converging at Fengfu. From the day of convergence onward, the Wei qi moves down one vertebral segment each day, which is why the time of malaria attacks is progressively delayed day by day. This is because the pathogenic qi initially lodges in the back region, and whenever the Wei qi reaches Fengfu, the couli (the interstices between skin and muscle, serving as the body's defensive barrier) open at that site; once they open, the pathogenic qi takes the opportunity to enter; once it enters, the disease attacks. This is the reason the attack time becomes increasingly delayed.
Starting from Fengfu, the Wei qi descends one segment per day, reaching the sacrum and coccyx after twenty-one days; on the twenty-second day it enters the interior of the spine, infusing into the Fuchong mai (the deep branch of the Chong mai, traveling within the spine); after another nine days, it emerges from Quepen (the supraclavicular fossa). Because the pathogenic qi ascends along with it, the condition progressively worsens. When the pathogenic qi binds inward into the five zang organs and spreads laterally to the moyuan (the region between the pleura and the diaphragm), the route of travel becomes longer and the pathogenic qi sits deeper, its movement slows, so it cannot attack daily—it must accumulate over an interval before attacking.
The Yellow Emperor asked: "Every time the Wei qi reaches Fengfu, the couli opens, and when it opens the pathogenic qi enters. But since the Wei qi descends one segment each day, what about when it is not at Fengfu?" Qi Bo said: "In reality, 'Fengfu' is not a fixed location. Wherever the Wei qi arrives, the couli will open; wherever the pathogenic qi lodges at a given vertebral segment, that location is its 'Fengfu.'"
The Yellow Emperor said: "Well spoken. Wind and malaria pathogens belong to the same category, yet wind persists constantly while malaria attacks and stops according to a regular schedule—why?" Qi Bo said: "Wind qi stays in place without moving, whereas malaria qi travels along the meridians deep into the body where it binds and accumulates. Therefore, attacks occur only when the Wei qi reaches the corresponding location."
The Yellow Emperor then asked Shaoshi (the Yellow Emperor's minister and physician): "I have heard that wind from the four seasons and eight directions harms people, some with cold and some with heat. In cold, the skin contracts and the couli close; in heat, the skin relaxes and the couli open. So do thief-like pathogenic winds (the collective term for abnormal seasonal qi and external pathogenic factors) invade the body casually, or must they wait for the vacuity pathogens at the correct positions of the eight nodes?"
Shaoshi replied: "It is not so. Thief-like pathogenic winds do not require a specific season to harm people. However, they invariably invade when the couli are open. If the couli are open, the invasion is deep, the internal condition is severe, and the attack is sudden and violent; if the couli are closed, the invasion is superficial, remaining only on the body surface, and the onset is slow and mild."
The Yellow Emperor asked: "If someone regulates cold and warmth appropriately and their couli have not opened, yet they suddenly fall ill—why is this?" Shaoshi replied: "Do you not know? Although a person may dwell in peace, the opening and closing of the couli, whether slow or rapid, fundamentally follow a fixed temporal rhythm."
The Yellow Emperor said: "Could you explain in detail?" Shaoshi said: "Humans correspond to Heaven and Earth and resonate with the sun and moon. Therefore, when the moon is full 🌕, the seawater surges to the west; human qi and blood also become replete and accumulated, the muscles become full, the skin becomes dense, the body hair becomes firm, the couli become tight, and greasy debris adheres to the body surface. At such a time, even when encountering thief winds, the evil qi invade shallowly rather than deeply. When the moon wanes 🌑, the seawater surges to the east; human qi and blood become vacuous, the Wei qi disperses, leaving only the form alone, the flesh diminishes, the skin relaxes, the couli open, the hair weakens, the couli thin, and the skin's debris sheds. At such a time, encountering thief winds causes deep invasion, and the onset of illness is sudden and violent."
The Yellow Emperor asked: "When someone suddenly dies suddenly or suddenly falls severely ill, why is this?" Shaoshi replied: "When one encounters the three vacuity (the confluence of three deficient states: decline of the year's qi, emptiness of the moon, and discord of the season), death comes swiftly; when one obtains the three repletion (the confluence of three replete states: abundance of the year's qi, fullness of the moon, and harmony of the season), evil qi cannot harm them."
The Yellow Emperor said: "May I ask what the three vacuity are?" Shaoshi said: "When one catches a year of weakened seasonal qi, encounters a period of the waning moon, and then loses the normal harmony of the season—at such a time being injured by thief winds—this is called the three vacuity. Thus, if a physician does not understand the principle of the three vacuity, no matter how skilled their art, they can only be considered a coarse practitioner."
The Yellow Emperor asked again: "May I ask what the three repletion are?" Shaoshi said: "When one catches a year of vigorous seasonal qi, encounters a period of the full moon, and additionally the season is harmoniously regulated—even if there are thief winds and evil qi, they cannot harm such a person."
The Yellow Emperor exclaimed with admiration: "Excellent exposition! The principles are brilliantly clear! Let me preserve this in a gilded casket and name it 'the three repletion.' However, this is but a discourse on the differences in individual disease manifestation."
The Yellow Emperor continued: "I further wish to know: within a single year, when the populace at large suffers from the same disease, what is the cause?" Shaoshi replied: "This requires observing the manifestations of the eight proper nodes (the signs of celestial phenomena, wind, and rain at the eight solar terms)."
The Yellow Emperor asked: "How does one observe it?" Shaoshi said: "To observe this, one begins at the winter solstice. On the winter solstice, Taiyi (the star deity of ancient astronomical divination who traverses the nine palaces, or the Big Dipper) is positioned at the Yezhe Palace (the northern Kan position, where the solstice resides). When Taiyi arrives, Heaven invariably responds with wind and rain. If the wind and rain come from the south, it is a vacuity wind (a wind blowing from the direction opposite the reigning position, considered harmful to people), a thief wind that can harm people. If the wind and rain arrive at midnight, the people are all asleep, and none encounter it, so for that year the populace suffers little illness. If the wind and rain arrive during the day, the people are lax and fail to guard against it, and all being struck by the vacuity wind, the population will therefore suffer much illness. The vacuity evil entering and lodging in the bones without dispersing outward, at the arrival of the coming of spring the yang qi flourishes greatly, the couli open, and if on the day of the coming of spring the wind blows from the west, the people again all encounter the vacuity wind. These two evils interlace, and the qi of the meridians becomes obstructed. Thus, whenever someone encounters this wind and meets this rain, it is called 'encountering the time-she.' If the year has a harmonious climate and few thief winds, the people suffer little illness and death; if the year abounds with thief winds and cold and warmth are discordant, the people suffer much illness and death."
The Yellow Emperor asked: "Does vacuity wind evil harming people discriminate between noble and base? How does one observe this?"
Shaoshi replied: "On the first day of the first month, Taiyi resides at the Tianliu Palace (the northeast Gen position, where the beginning of spring abides). On that day, if the northwest wind blows without rain, many will die. If a north wind blows at dawn on the first day of the new year, many deaths will occur in the spring. If the north wind continues on the morning of the first day, three in ten of the people will fall ill. If the north wind blows at noon on the first day, many deaths will occur in summer. If the north wind blows at evening on the first day, many deaths will occur in autumn. If the north wind persists throughout the day, six in ten will die of serious illness. On the first day, wind from the south is called 'drought realm'; from the west, called 'white bone' — the state will suffer calamity, with much death. On the first day, wind from the east portends winds that overturn houses and raise sand and stone, and the state will face great disaster. On the first day, wind from the southeast, deaths will follow in spring. If the first day's weather is mild with no wind, grain prices will be low and people will not fall ill; if the weather is cold and windy, grain prices will be high and the populace will suffer much illness. This is what is called 'observing the annual wind'—the wind that harms people.
In the second month (you position), if there is no wind, the people will suffer much heart and abdominal disease. In the third month (earth position), if it is not warm, the people will suffer much cold-heat disease. In the fourth month (si position), if it is not hot, the people will suffer much dan disease (damp-heat class of disorders). In the tenth month (shen position), if it is not cold, the people will suffer sudden death. All the winds spoken of above are violent winds that overturn houses, break trees, raise sand and stone, make the body hair stand on end, and cause the couli to open."
A Plain Reminder on Moon Phases and Daily Rhythms 🌙 Although modern evidence remains insufficient, the ancients' theory of moon phases and human biorhythms at least reminds us that the body's state is not constant but fluctuates in cyclical patterns. Paying attention to the rhythms of your own energy, moderately reducing expenditure and increasing rest during low periods, is a sensible life wisdom.
The Daily Practice of "When Righteous Qi Prevails Within, Pathogenic Influences Cannot Intrude" 💪 The three states of sufficiency (vigorous years, full moon, harmonious seasons) ultimately come down to the body's own fullness and stability. A reasonable diet, adequate sleep, moderate exercise, and stable emotions are all manifestations of "fullness." Rather than excessively fearing external "pathogenic influences," the focus should be on maintaining one's own internal equilibrium.
Related Concepts:
| Concept | Explanation |
|---|---|
| Wei Qi (Defensive Qi) | Qi that circulates outside the meridians and on the body surface; governs defense, warming, and regulation of sweat pore opening and closing |
| Fengfu (Wind Mansion) | A DU Meridian acupoint located one cun directly above the posterior hairline on the midline of the neck; extended as a functional concept in this chapter |
| Fuchong Meridian | The deep branch of the Chong Meridian, traveling within the spinal column, closely related to the spinal cord |
| Moyuan (Pleural-Diaphragmatic Space) | The region between the pleura and diaphragm; a "half-interior, half-exterior" zone where pathogenic qi penetrates deeply |
| Three Deficiencies/Three Sufficiencies | The combined state of decline or fullness in the year's fortune, moon phase, and seasonal order |
| Bazheng (Eight Orthodox Solar Terms) | The eight solar terms: equinoxes, solstices, and the four beginnings of seasons; or the eight cardinal directions |
| Xu Feng (Deficient Wind) | Wind blowing from the direction opposite to the prevailing seasonal wind direction; believed by the ancients to be most likely to harm people |
| Taiyi Yougong (Supreme One Touring the Nine Palaces) | The astronomical theory of Taiyi (Supreme One) touring the nine palaces according to seasons; categorized under the doctrine of five movements and six qi |
| Suilu (Annual Dew) | A phenomenon in which abnormal climate and irregular wind and rain over a year cause widespread illness among the populace |
| Couli (Striae and Interstices) | The gaps and openings between the skin and muscles; the primary channels through which external pathogenic influences invade |
Further Reading:
This content is based on ancient Chinese medicine classics and is intended solely for the study and research of traditional culture. It does not constitute any medical diagnosis, medication, or treatment advice; if you feel unwell, please seek medical attention promptly.
— Buguā