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Capítulo 49 de 78
黄帝内经·素问
This chapter aligns the three yin and three yang channels (Taiyang, Shaoyang, Yangming, Taiyin, Shaoyin, and Jueyin) with the months of the year, using the waxing and waning of yin and yang qi in nature to explain the manifestations of channel disorders.
The so-called swelling and pain in the lower back and buttocks is because the Taiyang channel corresponds to the first month, the month of the Tiger. In the first month, yang qi begins to rise from below the earth, but cold yin qi is still relatively strong; yang qi has not yet taken the dominant position, hence swelling and pain in the lower back and buttocks. The so-called hemilateral deficiency with limping is because in the first month, yang qi begins to thaw the ground and earth qi reaches outward, but the winter cold still leaves people with some insufficiency, hence one side is weak and walking is difficult. The so-called stiffness of the head and neck pulling at the back is due to yang qi surging upward in full force and contending with yin qi, hence rigidity of the head and neck. The so-called tinnitus is because yang qi causes all things to grow vigorously and leap upward, hence tinnitus. In severe cases, manic disorders and vertex ailments arise because yang qi is entirely gathered above while yin qi resides alone below, forming a pattern of lower deficiency and upper excess, hence mania and vertex disorders. The so-called "floating causes deafness" refers to disease in the qi aspect. The so-called invasion of evil into the interior causing loss of voice is because yang qi, after reaching its peak, turns to deficiency, hence the inability to produce sound. If essence qi is exhausted internally and the four limbs become cold, there will be loss of voice and paralysis of the limbs—this is kidney deficiency; when Shaoyin channel qi cannot reach upward, cold reversal (jue) develops.
The so-called heart and rib-side pain is because the Shaoyang channel qi is exuberant, and Shaoyang serves as the exterior of the heart. In the ninth month, yang qi is nearly exhausted and yin qi is becoming abundant, hence heart and rib-side pain. The so-called inability to turn the body sideways is because yin qi governs storage; when all things are stored, there is no movement, hence the body cannot turn. The so-called severe restlessness and agitation is because in the ninth month all things wither and grasses and trees shed their leaves; qi leaves the yang aspect and enters the yin aspect, and yang qi grows downward, hence agitation.
The so-called shivering with chills is because the Yangming channel corresponds to the fifth month, the month of the Horse—the time within abundant yang when yin qi first arises. Though yang qi is strong, yin qi begins to assert itself, hence shivering with chills. The so-called swelling of the lower leg and flaccidity of the thigh is because in the fifth month, within yang exuberance yin qi first arises; yang qi begins to decline in the fifth month, and yin qi rises upward to contend with yang qi, hence swelling of the lower leg and failure of the thigh to contract. The so-called qi counterflow with wheezing and development of edema is due to yin qi descending first and then rebelling upward; when pathogenic qi lodges between zang and fu, water pathology develops. The so-called chest pain and shortage of qi is because water qi lodges between zang and fu; water pertains to yin, and with yin qi internally, there is chest pain and shortage of qi. In severe cases, cold reversal of the limbs, aversion to seeing people and fire, and panic upon hearing the sound of wood, are due to yang qi and yin qi binding with each other, and water and fire repelling each other, hence fear and fright. The so-called desire to shut doors and windows and stay alone is due to the contention of yin and yang, with yang qi declining and yin qi predominant, hence the desire to dwell alone behind closed doors. The so-called inclination during illness to climb high and sing and to remove clothing and run about is due to the renewed struggle of yin and yang, with qi externally merging into the yang aspect, hence making one discard clothes and run. The so-called evil qi invading the collateral vessels causing headache, nasal congestion and discharge, and abdominal distension, is due to rebellion of Yangming channel qi, which is related to the upper collaterals and the Taiyin channel, hence headache, nasal congestion, and abdominal swelling.
The so-called abdominal distension is because the Taiyin channel corresponds to the eleventh month, the month of the Rat; in the eleventh month, the qi of all things is stored within, hence abdominal distension. The so-called upward rushing toward the heart manifesting as belching is due to exuberant yin qi moving upward into the Yangming channel; the Yangming luo connects to the heart, hence upward movement into the heart manifests as belching. The so-called vomiting after eating is because food fills and overflows upward, hence vomiting. The so-called relief of distension after defecation or passage of gas is because in the twelfth month yin qi gradually declines and yang qi is about to emerge, hence relief after elimination.
The so-called lower back pain is because Shaoyin pertains to the kidneys; in the tenth month, the yang qi of all things is injured, hence lower back pain. The so-called vomiting, coughing, and counterflow qi with wheezing is due to yin qi below and yang qi above; yang qi floats and disperses with nothing to anchor it, hence vomiting, coughing, and wheezing. The so-called inability to stand or sit for long, with blurred vision and seeing things indistinctly upon rising, is because the yin and yang of all things are unsettled and without a master; when autumn qi first arrives, light frost begins to fall and kills all things, and yin and yang are depleted within, hence blurred vision. The so-called shortage of qi and tendency to anger is due to yang qi failing to spread properly; when yang qi cannot reach outward, and liver qi should govern but cannot, there is a tendency to anger; this kind of anger is called "decanter reversal" (jian jue). The so-called fear as if someone is about to seize one is because autumn qi has not completely retreated; yin qi is scanty while yang qi enters within, and yin and yang contend, hence fear. The so-called aversion to the smell of food is due to weakness of stomach qi, hence aversion to the aroma of food. The so-called dark complexion like earth is due to autumn qi depleting within, hence change in complexion. The so-called cough with blood is due to injury of the yang channels; when yang qi has not yet filled the upper regions but the vessels are full, fullness leads to coughing, hence blood flows from the nose.
The so-called tui hernia and swelling in the lower abdomen of women is because the Jueyin channel corresponds to the third month, the month of the Dragon; the third month is yin within yang, and with pathogenic qi in the middle, hernia and lower abdominal swelling occur. The so-called lower back and spine pain with inability to bend or extend is because in the third month all things burst forth in splendor; all things only stretch upward and cannot bend downward, hence inability to bend and extend. The so-called tui long hernia and skin distension is because yin qi is also exuberant and the channels and vessels are full and obstructed, hence these symptoms. In severe cases, dry throat and internal heat arise because yin and yang contend and transform into heat, hence dry throat.
The central idea of this chapter is correspondence between heaven and humanity and the pairing of the six channels with the months. The ancients matched the three yin and three yang channels of the human body with the waxing and waning of yin and yang across the twelve months of the year, holding that the birth, growth, harvest, and storage of yang qi in nature influences the movement of channel qi in the human body. When the yin and yang qi of a particular month corresponds to a particular channel, that channel is predisposed to specific disorders.
For example, the Taiyang channel corresponds to the first month, when yang qi is just emerging while cold yin has not yet retreated, hence symptoms such as lower back and buttock swelling with pain and hemilateral weakness with limping—manifestations of "yang qi not yet taking its proper place." The Yangming channel corresponds to the fifth month, when yang is at its extreme and yin is born, hence alternating cold and heat, mental agitation, and other signs. The Shaoyin channel corresponds to the tenth month, when yang qi is injured, hence lower back pain, blurred vision, irritability, and other signs of internal depletion of essence qi.
The emphasis of this interpretation is not local anatomy, but rather grasping the temporal patterns and pathomechanism tendencies of disease from the angles of waning and waxing of yin and yang, upper-lower deficiency-excess, and inner-outer movement.
This chapter embodies the embryonic form of ancient chronomedicine, emphasizing the influence of seasons and climate on human physiology and pathology. Modern research has also confirmed that seasonal changes, light exposure, temperature, and humidity can affect blood pressure, immune function, mood, and the fluctuation of certain chronic diseases.
However, it should be viewed objectively: matching the six channel manifestations one-to-one with the months is a philosophical exercise in analogical categorization (qu xiang bi lei), not a modern anatomical or pathological mechanism. Many connections lack empirical evidence, and some explanations are clearly strained analogies. Therefore, this chapter is best read as a cultural document for understanding the ancients' "diagnosis in accordance with the seasons" way of thinking, and it cannot replace modern medical diagnosis.
Some general lifestyle guidance can be distilled from this chapter:
The above are merely suggestions for daily care from the perspective of traditional culture, not targeted at any specific disease.
Bugu Tip: This content is based on classical Chinese medical texts and is intended solely for traditional culture study and research. It does not constitute any medical diagnosis, medication, or treatment advice. Please consult a qualified physician promptly if you feel unwell.