Transmission from the Teacher

Huangdi said: I have heard that the former teacher possessed certain insights, kept in the heart and not written in books. I wish to hear these principles, to treasure them, to adopt them as guidelines and put them into practice—above, to treat the illnesses of the people; below, to nurture my own body and mind; so that the common people may be free from suffering, the high and low may be harmonious and close, virtue and grace may benefit later generations, descendants may have no worries, and these teachings may be transmitted to future ages without end. May I hear these principles?

Qibo said: Your question is profound indeed. Governing the people and nurturing oneself, governing others and governing oneself, governing small matters and governing great matters, governing a state and governing a family—never has there been success in governing by violating the natural patterns; only by following them can one succeed. What is meant by "following" includes not only the forward and reverse movements of yin and yang and the channels, and the forward and reverse flow of qi, but also that the common people all wish their intentions to be followed.

Huangdi said: How does one follow them?

Qibo said: When entering a state, ask about its customs; when entering a household, ask about its taboos; when entering a hall, ask about its rites; when facing a patient, ask what makes the patient comfortable.

Huangdi said: How does one make the patient comfortable?

Qibo said: When there is internal heat causing wasting-thirst disorder, it is appropriate to use cool or cold methods; for disorders of a cold nature, it is appropriate to use warm or hot methods. When the stomach has heat, it digests food quickly, causing a hollow, unsettled sensation in the heart and easy hunger. When the skin above the navel is hot, there is heat in the intestines, and the stool will be yellow like thin porridge. When the skin below the navel is cool, there is cold in the stomach, and abdominal distension will occur; when there is cold in the intestines, there will be intestinal rumbling and diarrhea with undigested food. When there is cold in the stomach and heat in the intestines, abdominal distension and diarrhea will occur; when there is heat in the stomach and cold in the intestines, the person will be prone to thirst, drink much water, and have pain and fullness in the lower abdomen.

Huangdi said: The stomach prefers cool and cold food and drink, while the intestines prefer warm and hot food and drink; these two are contradictory. How should one handle this appropriately? Moreover, the princes, nobles, and rulers who eat meat are arrogant and indulgent, following their whims, despising others, and no one can stop them. If one stops them, it goes against their wishes; if one follows them, it aggravates their condition. How should this situation be handled appropriately? Where should treatment begin first?

Qibo said: It is human nature that no one hates death and loves life. If you tell them the harm that the disease will bring, explain the benefits of following the treatment, guide them toward appropriate methods, and enlighten them to escape their suffering, even the most unreasonable person—how could they not comply?

Huangdi said: How does one treat them?

Qibo said: In spring and summer, first treat the external branch of the disease, then treat the internal root; in autumn and winter, first treat the internal root, then treat the external branch.

Huangdi said: When encountering those whose wishes contradict the needs of the disease, what should be done?

Qibo said: In such cases, with regard to food, drink, and clothing, one must also let them adapt to cold and warmth. When it is cold, do not let them feel bitterly cold; when it is hot, do not let them sweat excessively. As for food and drink, hot foods should not be so hot as to scald the mouth, and cold foods should not be so cold as to chill the teeth. When cold and warmth are balanced, the correct qi can be preserved, and the body will not be invaded by pathogenic qi.

Huangdi said: According to the theory of the fundamental viscera, one can assess the size of the five viscera and six bowels through the body’s form, the four limbs, the joints, and the muscles. Now, when princes, nobles, and rulers at court ask about this, who can personally palpate and massage them before answering?

Qibo said: The body’s form, the four limbs, and the joints are the protective barriers of the five viscera and six bowels; they are not like the face, which can be directly observed.

Huangdi said: I already know that the flourishing and decline of the qi of the five viscera can be observed from the face. How then does one observe from the four limbs and joints?

Qibo said: Among the five viscera and six bowels, the lung is the canopy of the five viscera. By observing the breadth of the shoulders and the depression of the throat, one can assess the condition of the lung.

Huangdi said: Good.

Qibo said: Among the five viscera and six bowels, the heart is the sovereign. The supraclavicular fossa is the pathway of the heart’s qi. By observing the fullness of the bones on either side of the supraclavicular fossa, one can assess the condition of the heart.

Huangdi said: Good.

Qibo said: The liver acts like a general, governing external defense. To understand whether the liver is firm, one can look at the size of the eyes.

Huangdi said: Good.

Qibo said: The spleen governs protection and is responsible for receiving the essence of water and grain. One can look at the condition of the lips and tongue to understand the auspiciousness or inauspiciousness of the spleen.

Huangdi said: Good.

Qibo said: The kidney governs external affairs and is responsible for distant hearing. One can look at the condition of the ears to understand the characteristics of the kidney.

Huangdi said: Good. I wish to hear the methods for assessing the six bowels.

Qibo said: Among the six bowels, the stomach is the sea of water and grain. If the bones are broad, the neck is thick, and the chest is expansive, the stomach can contain the five grains. The depth and length of the nasal passage can assess the large intestine. Thick lips and a long philtrum can assess the small intestine. A large lower eyelid indicates that the gallbladder qi is transverse. Nostrils that flare outward indicate that the bladder is prone to leakage. A raised central ridge of the nasal septum indicates that the triple burner functions with restraint. These are the methods for assessing the six bowels. If the upper, middle, and lower portions of the body are well-proportioned, then the five viscera and six bowels are sound and function well.