Lingshu · How the Hundred Illnesses First Arise

The text

The Yellow Emperor asked Qi Bo: The first arising of the hundred illnesses — they are all born of wind and rain, cold and heat, chill-damp and joy and anger. When joy and anger are not kept in measure, they injure the zang. Wind and rain injure the upper. Chill-damp injures the lower. The qi of the three regions injure in different kinds. I wish to hear how they meet. Qi Bo said: The qi of the three regions are each unlike. Some rise from yin, some from yang. Let me speak of their ways. When joy and anger are not kept in measure, they injure the zang; when the zang are injured, illness rises from yin. When chill-damp invades a vacancy, illness rises from below. When wind and rain invade a vacancy, illness rises from above. These are called the three regions. As for their overflowing and seeping, they cannot be counted. The Yellow Emperor said: I indeed cannot count them, and so I ask the former teacher. I wish to hear their Dao through to the end. Qi Bo said: Wind and rain, cold and heat — if they do not meet vacant pathogen, they cannot injure a person by themselves. Those who suddenly meet a violent wind and a driving rain and yet do not fall ill have no vacancy, and so the pathogen cannot injure them alone. This must be because the wind of vacant pathogen and the form of the body — two vacancies meeting — then lodge in the form. When two repletions meet, the flesh of the many is firm. Being struck by vacant pathogen: it is because of the season of heaven and the form of the body, joined with vacancy and repletion, that a great illness is then completed. Qi has a fixed lodging; it is named by the place. Above and below, inner and outer, are divided into three companies. Thus when vacant pathogen strikes a person, it begins at the skin. When the skin is slack, the interstices open; when they open, the pathogen enters by the hair; when it enters, it reaches deep; when deep, the hair stands; when the hair stands, there is a shivering, and so the skin hurts. If it stays and does not leave, it is transmitted to lodge in the network vessels. While in the networks, there is pain in the flesh; when the pain at times rests, the great channels take its place. If it stays and does not leave, it is transmitted to lodge in the channels. While in the channels, there is shivering and a tendency to startle. If it stays and does not leave, it is transmitted to lodge in the transport vessels. While in the transports, the six qi do not pass through the four limbs, so the limb-joints hurt and the lumbar spine grows stiff. If it stays and does not leave, it is transmitted to lodge in the hidden thoroughfare vessel. While in the hidden thoroughfare, the body is heavy and the person aches. If it stays and does not leave, it is transmitted to lodge in the intestines and stomach. While in the intestines and stomach, there is rumbling and abdominal distention. If the distention is more of cold, the intestines sound and there is undigested diarrhea, food not transforming; if more of heat, there is thin stool like deer droppings. If it stays and does not go out, it is transmitted to lodge outside the intestines and stomach, between the membranes of the origin, remaining on the vessels; it lingers and does not leave, and resting it becomes accumulation. It may lodge in the grandchild vessels, or in the network vessels, or in the channel vessels, or in the transport vessels, or in the hidden thoroughfare vessel, or in the sinews of the spine, or in the membranes of the intestines and stomach, joining above to the slack sinews. The overflowing of pathogenic qi cannot be fully discussed. The Yellow Emperor said: I wish to hear fully how these come to be so. Qi Bo said: When it lodges in the grandchild network vessels and becomes accumulation, the accumulation comes and goes, up and down, in the dwelling of the grandchild networks of the arm and hand. They float and are slack, and cannot hold the accumulation and stop it, so it comes and goes, shifting between the intestines and stomach. Water gathers, seeps, pours and irrigates, with a washing sound. If there is cold, there is flooding fullness and thunder-pulling, so at times a cutting pain. When it lodges in the yangming channel, it dwells beside the navel; after a full meal it grows larger, in hunger it grows smaller. When it lodges in the slack sinews, it resembles the accumulation of yangming: after a full meal there is pain, in hunger there is ease. When it lodges in the membranes of the intestines and stomach, there is pain linking outward to the slack sinews: after a full meal there is ease, in hunger there is pain. When it lodges in the hidden thoroughfare vessel, if you press it, it answers the hand and moves; when you lift the hand, hot qi goes down the two thighs as if scalded with boiling water. When it lodges in the sinews of the spine, behind the intestines: in hunger the accumulation is seen, after a full meal it is not seen, and pressing does not find it. When it lodges in the transport vessels, they are closed and do not pass; the fluids do not go down; the orifices dry and close. This is pathogenic qi entering from without to within, from above to below. The Yellow Emperor said: From the first arising of accumulation to its already being formed — how is it? Qi Bo said: The first arising of accumulation is born of obtaining cold; reversal then completes the accumulation. The Yellow Emperor said: How is the accumulation completed? Qi Bo said: Reversal-qi gives birth to tightness in the feet; tightness gives birth to cold in the shins; cold in the shins makes the blood vessels congeal and astringent; when the blood vessels congeal and astringent, cold qi rises into the intestines and stomach; entering the intestines and stomach, there is flooding distention; flooding distention presses the juices and foam outside the intestines so they gather and cannot scatter, and day by day they become accumulation. If one suddenly eats and drinks much, the intestines fill; if rising and resting are not kept in measure, if force is used beyond measure, the network vessels are injured. If the yang networks are injured, blood overflows outward. Blood overflowing outward is nosebleed. If the yin networks are injured, blood overflows inward. Blood overflowing inward is blood afterward. If the networks of the intestines and stomach are injured, blood overflows outside the intestines. Outside the intestines there is cold; juices and foam contend with the blood, then join, congeal and gather, and cannot scatter — and the accumulation is formed. If one is suddenly struck from without by cold, or inwardly injured by worry and anger, then qi rises in reversal; when qi rises in reversal, the six transports do not pass; warm qi does not travel; congealed blood wraps and stores itself and does not scatter; the fluids seep astringently, lodge and do not leave — and accumulations are all formed. The Yellow Emperor said: As for those that arise from yin — how is it? Qi Bo said: Worry and thought injure the heart. Doubled cold injures the lung. Fury and anger injure the liver. Drunkenness and then entering the inner chamber, sweat going out into the wind, injure the spleen. Using force beyond measure, or entering the inner chamber, sweating, and then bathing, injures the kidney. These are how the inner and outer three regions give birth to illness. The Yellow Emperor said: Good. How is it treated? Qi Bo answered: Observe where it hurts, so as to know what it answers. Surplus and insufficiency: where one should supplement, supplement; where one should drain, drain. Do not go against the season of heaven. This is called the utmost treatment.

The line

The Yellow Emperor asked Qi Bo: The first arising of the hundred illnesses — they are all born of wind and rain, cold and heat, chill-damp and joy and anger.

The note

The hundred illnesses first arise from wind and rain without, from joy and anger within. Either end can open a person. First arising is while they are still in the fine hairs and the interstices.