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Capítulo 50 de 81
黄帝内经·灵枢
Overall Paraphrase
(The original text of this chapter contains some graphically similar mistaken characters, such as "qing feng" should be "wen feng" and "jiu ting" should be "jiu bo." The following is a paraphrase based on the transmitted version and the Yijia Jing.)
The Yellow Emperor asked Shao Yu: "Several people walk together and stand together. They are the same age, and their clothing is equally thick or thin. Suddenly they encounter violent wind and torrential rain. Some fall ill, and some do not. Sometimes all fall ill, and sometimes none fall ill. What is the reason for this?"
Shao Yu said: "In spring there are more warm winds 💨, in summer more yang-heat winds 🔥, in autumn more cool winds 🍂, and in winter more cold winds ❄️. When the wind pathogens of these four seasons injure people, the conditions they cause are each different."
The Yellow Emperor asked: "How do the winds of the four seasons injure people?" Shao Yu said: "People with yellowish skin and thin skin with weak flesh cannot withstand the deficient wind of spring (the improper qi of the four seasons, wind pathogen that takes advantage of deficiency to enter); people with white skin and thin skin with weak flesh cannot withstand the deficient wind of summer; people with greenish skin and thin skin with weak flesh cannot withstand the deficient wind of autumn; people with red skin and thin skin with weak flesh cannot withstand the deficient wind of winter."
The Yellow Emperor asked: "Do people with dark skin never fall ill?" Shao Yu said: "People with dark skin and thick skin with firm flesh are indeed not easily injured by the deficient winds of the four seasons. If a person has thin skin, flesh that is not firm, and a complexion that is not pure, when encountering a deficient wind during long summer (the period between summer and autumn), they may fall ill. Those with thick skin and firm flesh will not fall ill even when encountering a deficient wind during long summer. Those with thick skin and firm flesh must be externally attacked by cold pathogen and internally invaded by cold — repeatedly affected by cold both internally and externally — and only then will they fall ill."
The Yellow Emperor said: "Well said."
The Yellow Emperor also said: "Whether a person can endure pain or cannot endure pain is not a matter of courage or cowardice. Among brave warriors, there are those who cannot endure pain; when facing danger they can charge forward, but when encountering pain they stop. Among cowards, there are those who can endure pain; when hearing of danger they become fearful, but when encountering pain they remain unmoved. Among brave warriors who can endure pain, encountering danger does not cause fear, and encountering pain does not cause them to flinch. Among cowards who cannot endure pain, when encountering danger and pain, their eyeballs turn, their faces twitch, they are too frightened to speak, they startle and their qi becomes disordered, their complexion changes, as if they have died and then come back to life. I have observed these phenomena but do not know their cause."
Shao Yu said: "Whether one can endure pain depends on the thickness or thinness of the skin and the firmness or looseness of the flesh — it is not a matter of courage or cowardice."
The Yellow Emperor said: "I wish to hear how courage and cowardice are formed."
Shao Yu said: "Brave warriors have deep-set eye sockets with steady, firm gazes; their brows and foreheads are broad, and their qi flows straight; their Sanjiao (one of the six fu organs, governing the passage of qi and water) has horizontal striations; in their hearts qi is upright and straight; their livers are large and firm; and their gallbladder qi is full and horizontal. When anger arises, their qi becomes abundant, their chest cavities expand, liver qi rises and gallbladder qi overflows, the corners of their eyes seem about to split as both eyes open wide, their hair stands on end, and their faces turn blue. This is the physical foundation from which brave warriors are formed."
The Yellow Emperor said: "I wish to hear how cowards are formed." Shao Yu said: "Cowards have large eyes but unsettled spirit-qi; yin and yang qi are not harmonized; the Sanjiao striations are vertical and lax; the xiphoid process of the sternum is short and small; the liver system is relaxed; gallbladder qi is not full but slack and loose; the stomach and intestines are straight and not curved; and the flanks are soft and empty. Even when greatly enraged, their qi cannot fill the chest. Although the liver and lungs rise together, after the qi declines, it falls back down again. Therefore, they cannot sustain anger for long. This is the physical foundation from which cowards are formed."
The Yellow Emperor asked: "When a coward drinks wine, in anger they do not avoid brave warriors. Which viscus causes them to behave this way?" Shao Yu said: "Wine is the essence of water and grain, the fluid produced from cooked grain. Its qi is piao han (swift, rash, and slippery) 🔥. When wine enters the stomach, it causes the stomach to become distended and full, qi to rise rebelliously and fill the chest, the liver qi to float upward, and gallbladder qi to become horizontal and distended. At this moment, indeed, such a person can be compared to a brave warrior. But when the wine qi fades, they will feel regret. This state of being comparable to a brave warrior and not knowing to avoid confrontation is called 'jiu bo' — that is, behavioral disorder after drinking."
Physical constitution determines whether disease occurs
This chapter begins by discussing "when all are equally exposed to wind, why do some fall ill and others not?" Shao Yu's answer points to physical constitution: those with thick skin and firm flesh are not easily affected by pathogens, while those with thin skin and weak flesh are susceptible to deficient winds. This is consistent with the Suwen saying, "When upright qi is preserved within, pathogens cannot interfere," and "Where pathogens gather, qi must be deficient." The ancients believed that whether external pathogens cause disease depends not only on the strength of the external pathogen but also on the body's own ability to resist.
Five-color—five-element—four-season constitutional model
The original text assigns yellow, white, green, red, and black to spring, summer, autumn, winter, and long summer respectively. The internal logic is the five-element generation and control cycle: spring wood controls earth, so those with yellow skin, thin skin, and weak flesh are not equal to spring wind; summer fire controls metal, so those with white skin, thin skin, and weak flesh are not equal to summer wind; autumn metal controls wood, so those with greenish skin, thin skin, and weak flesh are not equal to autumn wind; winter water controls fire, so those with red skin, thin skin, and weak flesh are not equal to winter wind; long summer earth controls water, so those with dark skin, thin skin, and weak flesh are not equal to long summer deficient wind. This is an early model of constitutional classification based on correspondence between heaven and humankind.
"Enduring pain" and "courage/cowardice" are two separate dimensions
This chapter clearly states: whether one can endure pain depends on skin thickness and the firmness or slackness of muscles; courage and cowardice are related to the spirit of the eyes, the striations of the Sanjiao, the form of the liver and gallbladder, and the structure of the chest and flanks. In other words, a person who can endure pain is not necessarily brave; a brave person does not necessarily endure pain. The two must not be confused.
Courage and cowardice have a "physical-structural" foundation
The ancients believed courage and cowardice were not purely psychological traits but had a basis in bodily structure. Brave warriors have deep-set eyes, horizontal Sanjiao striations, large and firm livers, and full and horizontal gallbladder qi; therefore, when angry, their qi is abundant and their chests expand. Cowards have large but unfixed eyes, vertical Sanjiao striations, relaxed liver systems, and insufficient and slack gallbladder qi; therefore, even when angry, their qi cannot fill the chest. This reflects the unity of form and spirit: bodily structure influences emotional expression.
Wine qi is swift and rash; it temporarily alters courage and cowardice
Wine is the essence of water and grain, the fluid of cooked grain. Its qi is swift, hurried, and slippery. When it enters the stomach, it causes stomach distention, rebellious qi rising to fill the chest, liver qi floating upward, and gallbladder qi expanding horizontally. Therefore, a coward, after drinking, can briefly stand up to a brave warrior. But this is the effect of an external substance, not the person's true courage or cowardice. When the qi of the wine fades, they return to their original state. The ancients called this "jiu bo."
Constitution and disease onset: Modern medicine also recognizes that nutritional status, baseline health, skin barrier function, and immune function influence the response to infection and cold. However, mechanically correlating skin color with the four seasons is a five-element classification model and cannot be taken as a basis for modern epidemiological understanding.
Pain tolerance: Modern research confirms that pain threshold and tolerance are influenced by genetic, neurological, psychological, cultural, and other factors. The ancients' attribution of pain endurance to skin and muscle thickness and firmness is a macroscopic observation with some plausible elements, but it is not the whole story.
Courage and cowardice related to viscera form: Using eye depth, Sanjiao striations, and liver/gallbladder size to determine courage or cowardice has no modern anatomical evidence. It is more of an ancient observational model of "form-spirit correlation." It should not be interpreted literally, yet the idea that "the bodily state influences emotional expression" remains thought-provoking.
Alcohol and behavior: Alcohol depresses the central nervous system, reducing fear and judgment, and can lead to impulsive behavior — consistent with the description of "jiu bo." However, the ancients' view that "wine qi is swift and rash" is a principled understanding within their framework, while modern perspectives emphasize the potential health hazards of alcohol — in particular, one should not use alcohol to boost courage or regulate emotions.
Avoid deficient winds; protect the body surface: During seasonal transitions or when sweating in a draft, one should promptly add clothing and wipe off sweat to avoid direct cold wind. The ancients emphasized that "deficient winds" enter through deficiency, so daily protection against wind-cold is still worth following.
Strengthen the body; make the flesh firm: Moderate exercise and regular routines help maintain dense skin and fleshy texture, as well as strong sinews and bones. The key is long-term consistency, not pursuing extreme cold tolerance or pain endurance.
Do not judge courage by pain endurance: The ability to endure pain varies individually. One should not evaluate a person's bravery or weakness based on their pain tolerance, nor should one feel ashamed of fearing pain. When pain or discomfort appears, one should pay attention to the body's signals in a timely manner.
Treat alcohol rationally: This chapter says wine can temporarily alter courage and cowardice, but this is merely an external disturbance, not genuine emotional capacity. Daily life should involve moderate or zero alcohol consumption, and in particular, one should never use alcohol to process emotions, boost courage, or aid sleep.
Related Concepts
Further Reading
— Bu Gua's note: 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 prescription, or treatment advice. If you feel unwell, please seek medical attention promptly.