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Capítulo 17 de 81
黄帝内经·灵枢
Overall Paraphrase
The Yellow Emperor asked to hear the principles of the "Measurement of the Vessels." Qi Bo replied: The six yang vessels of the hands run from the hands to the head, each five chi in length—six in total, making three zhang. The six yin vessels of the hands run from the hands to the chest, each three chi and five cun—six in total, making two zhang and one chi. The six yang vessels of the feet run from the feet upward to the head, each eight chi—six in total, making four zhang and eight chi. The six yin vessels of the feet run from the feet to the chest, each six chi and five cun—six in total, making three zhang and nine chi. The Qiao vessels (the vessels governing left-right balance of the body and the opening-closing of the eyelids) ascend from the feet to the eyes, each seven chi and five cun—two in total, making one zhang and five chi. The Governor Vessel and the Conception Vessel are each four chi and five cun—two in total, making nine chi. The grand total sums to sixteen zhang and two chi—this is the body's major "Great Pathway of Vessels," through which qi travels.
The primary vessels form the deep trunks; the branches running horizontally from the primary vessels are called connecting vessels (luo); further branches of the connecting vessels are called minute connecting vessels (sunluo). If pathogenic qi abounds in the minute connecting vessels and blood movement becomes congested, the ancients held that one should promptly prick the vessels to let blood out; when pathogenic qi is exuberant, use reducing methods; when righteous qi is deficient, medicinal tonification may be applied.
The essence qi of the five viscera constantly rises internally to reach the seven orifices of the head. Thus, lung qi links to the nose: when lung qi is harmonious, the nose can distinguish fragrance from odor; heart qi links to the tongue: when heart qi is harmonious, the tongue can distinguish the five flavors; liver qi links to the eyes: when liver qi is harmonious, the eyes can distinguish the five colors; spleen qi links to the mouth: when spleen qi is harmonious, the mouth can distinguish the five grains; kidney qi links to the ears: when kidney qi is harmonious, the ears can hear the five tones. When the five viscera lose their normal function, the seven orifices become obstructed; when the six bowels are not in harmony, pathogenic qi may stagnate and form swellings or abscesses.
Therefore, when pathogens lodge in the six bowels, the yang vessels become disharmonious; when yang vessels are disharmonious, qi movement becomes stagnant; when qi is stagnant, yang qi predominates excessively. When yang qi is too exuberant, the yin vessels become impeded; when yin vessels are impeded, blood movement stagnates; when blood movement stagnates, yin qi predominates excessively. When yin qi is too exuberant, yang qi cannot circulate to warm and nourish—this is called "Guan" (barrier); when yang qi is too exuberant, yin qi cannot circulate to moisten and nourish—this is called "Ge" (repulsion). When both yin and yang are exuberant and can no longer nourish each other, this is called "Guange." When Guange occurs, one often cannot live out their natural lifespan but dies prematurely.
The Yellow Emperor asked: Where do the Qiao vessels originate, and where do they end? What qi nourishes and moves them? Qi Bo replied: The Qiao vessel is a branch of the foot-shaoyin vessel. It arises behind the ankle bone (the bony prominence anterior and inferior to the medial malleolus), ascends above the medial malleolus, continues straight up along the medial thigh to enter the genital region, then ascends within the chest to enter the supraclavicular fossa, emerges anterior to the Renying point, enters the cheek region, and connects to the inner canthus. There it meets the foot-taiyang vessel and yang qiao vessel, and ascends together. When the yin and yang qiao qi merge and circulate back and forth, the eyes are moistened and nourished; when qi fails to nourish, the eyes cannot close properly.
The Yellow Emperor asked: Qi moves only through the five viscera but does not nourish the six bowels—why is this? Qi Bo replied: Qi cannot stop moving; it is like flowing water, like the movement of the sun and moon that never ceases. Thus, the yin vessels nourish the five viscera, and the yang vessels nourish the six bowels, forming a ring with no beginning and no end—ending only to begin again. The overflowing qi irrigates the viscera internally and moistens widely the couli (interstitial spaces of the skin and flesh) externally.
The Yellow Emperor asked: Among the Qiao vessels, there are the yin qiao and the yang qiao—which one is counted within this general measurement of vessels? Qi Bo replied: In men, the yang qiao is taken as the primary vessel counted in the measurement; in women, the yin qiao is taken as the primary vessel counted in the measurement. What is counted is considered the primary vessel; what is not counted is considered a connecting vessel.
Note: Due to some errors introduced during transmission of the original text, certain characters such as "颁脉" and "缺脉" should according to standard editions be read as "跷脉," and "明脉" should be read as "阴脉." The above paraphrase follows the collation of the standard Lingshu text.
Establishing a Mathematical Model of Qi-Blood Circulation via "Measurement of Vessels"
This chapter assigns specific lengths to the twelve primary vessels, the Qiao vessels, the Governor and Conception vessels, totaling sixteen zhang and two chi, referred to as the "Great Pathway of Qi Vessels." This is not anatomical measurement in the modern sense but rather the ancients' use of numerical reasoning to describe the total length of pathways through which qi and blood circulate—demonstrating a mode of cognition that holds "internal structures can be measured."
Hierarchical Structure: Primary Vessels—Connecting Vessels—Minute Connecting Vessels
The ancients divided the vascular system into three layers: primary vessels deep within as trunks, horizontal branches as connecting vessels, and further branches of connecting vessels as minute connecting vessels. This resembles a tree-like structure from trunk to limbs to twigs, indicating that qi and blood do not move along a single line but through a network system that gradually goes from coarse to fine, from interior to surface.
Five Viscera Connected to Seven Orifices: Holistic Correspondence Between Internal Organs and External Openings
Lung-nose, heart-tongue, liver-eyes, spleen-mouth, kidney-ears—this is an important component of the Chinese medical theory of "Visceral Manifestation." The "connection" here does not refer to an actual physical tube directly linking them, but rather the idea that the flourishing and decline of the essence qi of the five viscera can be reflected in the corresponding orifices. Therefore, when the functions of the seven orifices are abnormal, the ancients did not look only at the local site but sought the cause from the five viscera.
Yin-Yang Barrier and Repulsion: A Critical Model of Systemic Imbalance
"Guan" occurs when yin qi is too exuberant and yang cannot enter; "Ge" occurs when yang qi is too exuberant and yin cannot exit. When yin and yang mutually repel and fail to communicate, this is called "Guange." This is the ancients' theoretical summary of severe systemic functional disorder and grave yin-yang imbalance—a critical condition that emphasizes yin and yang are mutually rooted and indispensable.
Qiao Vessels Govern Eye Opening-Closing and the Merging of Yin-Yang Qi
The yin qiao and yang qiao converge at the inner canthus; when their qi "merges and returns mutually," the eyes are moistened and can open and close. The ancients thereby explained the relationship between sleep, wakefulness, and eyelid movement through the Qiao vessels, attributing sleeping-waking disorders to disharmony of the yin and yang qiao vessels.
Vessel Qi Circulates Like a Ring without End
The yin vessels nourish the viscera, the yang vessels nourish the bowels; qi moves like flowing water, like the movement of the sun and moon, circulating ceaselessly. This embodies the Chinese medical outlook of "ceaseless movement" — emphasizing that the vitality of life lies in motion, not in stillness.
Vessel measurement data have the nature of a theoretical model
The figure of sixteen zhang and two chi is a standardized model constructed by medical scholars of the Warring States and Qin-Han periods, reflecting a style of thought that uses numbers to organize the understanding of human patterns. If tested against modern anatomical measurement, it would clearly not correspond; yet as a "theoretical model," it carries the ancients' overall grasp of the circulation of qi and blood, and should not be simplistically dismissed as backward or absurd.
Five viscera connecting to seven orifices reflects a holistic view, not anatomical pathways
Modern medicine has indeed found that many internal diseases can affect the sensory organs—eyes, ears, nose, tongue—for example, metabolic diseases, immune diseases, and neurological disorders all may present with orifice manifestations. However, statements like "the lung opens into the nose" or "the kidney opens into the ears" belong to ancient categorization and empirical summary, not equivalent to modern anatomical or physiological correspondences; they should be understood as a window onto the ancients' diagnostic reasoning.
Pricking the collaterals to reduce excess and tonifying deficiency reflect diagnostic differential thinking
"For exuberance, reduce; for deficiency, administer medicine to tonify" is the early approach of separating treatment for excess and deficiency patterns, consistent with the later principle of "excess is reduced, deficiency is tonified." However, the phrase "when exuberant with blood, promptly punish it" involves bloodletting—a method of ancient medical practice that should not be self-attempted in modern times; all treatments should be carried out in regular medical institutions.
Guange is a holistic judgment of critical states
The ancients had already observed that when inner-outer, yin-yang communication is severely impaired, the condition becomes perilous. This echoes in line of thinking with modern judgments of systemic deterioration in severe infection or terminal organ failure, but "Guange" is not the name of a specific modern disease and cannot be directly substituted.
The relationship between Qiao vessels and eyelids/sleep reflects sound observation
The ancients connected eyelid opening and closing, sleeping and waking, with the Qiao vessels, showing that they noticed the correlation between eyelid movement and mechanisms controlling wakefulness and sleep at an early stage. Modern medicine holds that eyelid opening and closing are performed by the orbicularis oculi and levator palpebrae superioris muscles under nervous control, and sleep is regulated by the central nervous system. The explanatory systems differ, but the phenomena observed align.
Follow the circadian rhythm; protect the transition between yin and yang
The Qiao vessels are related to the opening and closing of the eyes; the ancients emphasized rising with the sun and resting with its setting. In modern life, try to avoid staying up late or reversing day and night, giving the body a stable daily rhythm, which benefits overall recovery.
The seven orifices are "windows" of bodily information
Nasal congestion, tinnitus, dry eyes, bitter taste, abnormal smell or taste—these are not necessarily isolated minor issues; they may be reminders of systemic imbalance. If they persist, seek regular medical evaluation rather than self-prescribing "clearing fire," "detoxifying," or enduring them long-term.
Maintain the flow of qi and blood; avoid long periods of sitting or lying
Vessel qi moves "like a ring without end," and life values circulation. In daily life, engage in moderate walking, stretching, and limb movement, and avoid maintaining a fixed posture for a long time, which may lead to stagnation of qi and blood. This is only general lifestyle advice and is not directed at any specific disease.
Keep the emotions calm; prevent excessive yin or yang
Great anger, anxiety, or prolonged stress may cause qi stagnation or hyperactive yang; excessive depression or suppression may prevent qi from spreading. Keeping emotions stable helps harmonize yin and yang and reduces the risk of extreme imbalance such as "Guange."
Related Concepts
Further Reading
This content is based on classical Chinese medical texts and is provided solely for traditional cultural learning and study; it does not constitute any medical diagnosis, prescription, or treatment advice. If you feel unwell, please seek medical attention promptly.