Differentiation of the Five Kinds of Blockage and Body Fluids

The Yellow Emperor asked Qi Bo: "When grain and water enter the mouth and are transported to the intestines and stomach, the fluids they transform are divided into five kinds. When the weather is cold and clothing is thin, they turn into urine and qi; when the weather is hot and clothing is thick and warm, they turn into sweat; when there is grief and qi rebellion, they turn into tears; when there is heat in the middle burner and stomach qi becomes relaxed, they turn into saliva. When pathogenic qi rebels within the body, it causes the qi mechanism to become blocked and not move; when qi does not move, water swelling disease forms. I know these conditions, but I do not know how they arise; I wish to hear the reasoning."

Qi Bo said: "Grain and water both enter from the mouth. The five flavors they transform are each infused into their respective seas (referring to the five viscera). The fluids and humor each follow their own pathways. Therefore, the triple burner distributes qi, using it to warm and nourish the muscles and to moisten and fill the skin. This is called 'thin fluid' (jin). That which flows but does not disperse is called 'thick fluid' (ye). When the weather is hot and clothing is thick, the interstices open and discharge, so there is sweating. When cold qi stays between the fleshy divisions, it congeals into froth and causes pain.

When the weather is cold, the interstices close, and damp qi cannot move. The water fluids flow downward and stay in the bladder, becoming urine and qi.

In the five viscera and six bowels, the heart is the ruler, the ears govern hearing, the eyes govern seeing, the lungs are like the prime minister, the liver is like the general, the spleen is like the guardian, and the kidneys are like the officials in charge of external affairs. Therefore, the fluids and humor of the five viscera and six bowels all upwardly seep and infuse into the eyes. When the heart experiences grief and qi congeals together, the heart system becomes tense. When the heart system is tense, it causes the lung lobes to lift upward; when the lung lobes lift upward, the fluids overflow upward. The heart system and lungs cannot always be lifted upward; at times they go up, at times they go down, so there is coughing and tears flow.

When there is heat in the middle burner, the stomach can digest grain and water. When it digests grain and water, the parasites move up and down. The intestines and stomach become full and replete, so stomach qi becomes relaxed. When stomach qi is relaxed, qi rebels upward, so saliva flows out.

The fluids transformed from the five grains blend and become a fatty, oily substance. Inwardly, they seep into the bone cavities, supplement and benefit the brain and marrow, and downwardly flow and infuse into the inner thighs.

When yin and yang qi are not harmonized, it causes the fluids to overflow and downwardly flow and infuse into the yin region. The marrow fluids all diminish and flow downward; when the downward flow is excessive, it leads to depletion and damage. Thus, there is pain in the lower back and back, and soreness in the lower legs. The pathways for the movement of yin and yang qi become blocked, the four seas are obstructed, the triple burner cannot discharge, the fluids cannot be properly transformed, and the qi of grain and water moves together within the intestines and stomach, dividing and flowing into the ileum, staying in the lower burner, and unable to seep into the bladder. Hence, the lower burner becomes distended and full, the water fluids overflow, and this becomes water swelling disease. This is the disorder and normalcy of the five transformations and distributions of fluids and humor."