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Capítulo 58 de 81
黄帝内经·灵枢
The Yellow Emperor asked: "You say that thief-wind and evil qi (external pathogenic factors such as wind and cold) harm the human body and cause illness. Yet some people neither leave their sheltered places nor step outside their houses or underground dwellings, and yet they suddenly fall ill — it is not that they failed to avoid thief-wind and evil qi, but rather that they never encountered them at all. How do you explain this?"
Qi Bo replied: Such people all have old injuries first. Either they were once harmed by dampness, and the damp pathogen lies latent within the blood vessels and between the flesh and sinews (the spaces between muscles), lingering for a long time without dispersing; or they once fell from a height or suffered a blow, and stagnant blood (bruised blood) accumulated within the body without being resolved. At this point, if there is a sudden imbalance of joy and anger, improper diet, or maladjustment of cold and warmth, then the cou li (the passageways through which the skin opens and closes) become blocked and impassable; and when the cou li do open, the person faces wind and cold head-on. The qi and blood congeal, and mutually collude with the latent old pathogen within the body, giving rise to cold bi (painful obstruction syndrome caused by cold congealing and stagnating). If there is heat within the body, the person will sweat; when sweating occurs, the pores open wide, and wind evil takes advantage of the deficiency to enter — therefore, even if one has not directly encountered thief-wind and evil qi, there must always be an internal latent cause combined with a new trigger that together lead to the onset of disease.
The Yellow Emperor pressed further: "What you have described are all things the patient can perceive on their own. But there are those who encounter neither evil qi nor emotional disturbances such as fear or anxiety, and yet suddenly fall ill — what is the reason for this? Could it be a matter of ghosts and spirits?"
Qi Bo replied: This situation is also not caused by ghosts or spirits, but rather by old pathogens (latent, as-yet-unmanifested evil qi) remaining within without having broken out, combined with matters of hatred or longing in the heart that cause the qi and blood to be disturbed inwardly, so that the old and new streams of pathogenic qi struggle against each other. The cause of the illness is extremely subtle — unseen and unheard — which is why it seems 'as if ghosts and spirits were at work.' In reality, it is merely that the cause of the disease is hidden and difficult to discern.
The Yellow Emperor asked: "Then how is it that some patients can be cured by zhu you (an ancient method of treating illness through incantations and explaining the cause of the disease)? What is the principle behind this?"
Qi Bo replied: In ancient times, shaman-healers were able to achieve results with zhu you because they understood the mutual overcoming of all diseases (the laws of mutual constraint among diseases) and knew in advance the origin from which the disease arose. Therefore, they could cure through prayers and explanations of the cause. The key lies in a person's ability to understand the pattern — not in the power of ghosts or spirits.
The central academic idea of this chapter is the concept of 'latent pathogens' and the pathogenesis theory of 'internal and external factors combining to cause disease.'
The Yellow Emperor raises an extremely pointed question: since externally contracted diseases require 'thief-wind and evil qi' to invade from outside, why does someone staying home suddenly fall ill? Qi Bo's reply unfolds layer by layer, constructing a complete model of disease onset:
Going even deeper is the notion of 'like ghosts and spirits, yet not ghosts and spirits.' When the cause of disease is extremely subtle — old pathogens hidden deeply, emotional changes leaving no trace — people attribute inexplicable illnesses to ghosts and spirits. With the nine characters 'invisible to the eye, inaudible to the ear, therefore like ghosts and spirits,' Qi Bo precisely identifies the cognitive error of the ancients: it is not that ghosts and spirits are at work, but rather that the causal relationship is too deeply hidden.
The final discussion on zhu you brings everything to a point of culmination: 'One who knows in advance the origin from which the disease arises can cure it with zhu.' Shaman-healers could treat illness because they grasped the cause of the disease ('knowing in advance') — not because their rituals possessed supernatural power. In effect, this pulls 'zhu you' out of the mire of mysticism and explains why it could be effective: understanding the source of illness + psychological suggestion + comprehensive intervention.
Points worthy of recognition:
The 'latent pathogen' theory finds intriguing resonances with modern infectious disease science, such as latent infection — Mycobacterium tuberculosis, EB virus, and varicella-zoster virus (VZV) can remain hidden in the body for years and reactivate when immunity declines. Herpes zoster is an excellent modern parallel to 'old pathogens remaining without breaking out, and because the heart harbors hatred and longing, the qi and blood become internally disturbed' before recurrence. This shows that although the ancients had no concept of microorganisms, they captured the essence of the 'latency–reactivation' pattern of disease with the term 'latent pathogen.'
The 'internal and external combined causation' view of disease onset also bears remarkable similarity to the modern biopsychosocial model of medicine. The ancients recognized that disease is not caused by a single external factor alone, but is the result of the interaction between the internal environment (upright qi, emotions, old pathogens) and the external environment (the six excesses, diet, climate). This holistic perspective transcends the mechanical linear thinking of 'one cause, one disease.'
Historical limitations:
The ancients had no way of knowing specific pathogens, and could only explain disease through abnormalities of 'qi' (evil qi, old pathogens, internal disturbance of qi and blood). This is a philosophical abstraction rather than precise biological description. The specific methods of 'the mutual overcoming of all diseases' and zhu you have been lost to history, and what 'cures' they produced contained a considerable measure of placebo effect — modern research has confirmed that ritualized treatments can relieve certain functional ailments to some degree, but they can never replace evidence-based medicine.
This content is based on classical Chinese medical texts and is provided solely for the study and cultural appreciation of traditional knowledge. It does not constitute any medical diagnosis, medication, or treatment advice. If you feel unwell, please seek medical attention promptly.