Suwen · The Jade Mechanism and the True Zang

The text

The Yellow Emperor asked: The spring pulse is like a string. How is it a string? Qi Bo replied: The spring pulse is the liver, the wood of the east, that by which the ten thousand things first come to birth. Therefore its qi comes soft, weak, light, empty, and slippery, upright and long — hence it is called string. The reverse of this is illness. The Emperor said: How is it the reverse? Qi Bo said: If its qi comes replete and strong, this is called too much — the illness is on the outside. If its qi comes not replete and faint, this is called not enough — the illness is in the center. The Emperor said: When the spring pulse is too much or not enough, what are the illnesses in each case? Qi Bo said: Too much makes a person forgetful, suddenly dizzy and covered, with vertex illness. Not enough makes a person have pain in the chest drawing to the back, and below, fullness in both flanks. The Emperor said: Good. The summer pulse is like a hook. How is it a hook? Qi Bo said: The summer pulse is the heart, the fire of the south, that by which the ten thousand things flourish and grow. Therefore its qi comes abundant and leaves in decline — hence it is called hook. The reverse of this is illness. The Emperor said: How is it the reverse? Qi Bo said: If its qi comes abundant and leaves also abundant, this is called too much — the illness is on the outside. If its qi comes not abundant and leaves, on the contrary, abundant, this is called not enough — the illness is in the center. The Emperor said: When the summer pulse is too much or not enough, what are the illnesses in each case? Qi Bo said: Too much makes a person hot in the body with pain in the skin, becoming a spreading soak. Not enough makes a person troubled in the heart; above one sees coughing and spitting, below there is leaking of qi. The Emperor said: Good. The autumn pulse is like the floating. How is it floating? Qi Bo said: The autumn pulse is the lung, the metal of the west, that by which the ten thousand things are gathered and completed. Therefore its qi comes light, empty, and floating, arriving urgent and leaving scattered — hence it is called floating. The reverse of this is illness. The Emperor said: How is it the reverse? Qi Bo said: If its qi comes hairlike, firm in the center and empty on both sides, this is called too much — the illness is on the outside. If its qi comes hairlike and faint, this is called not enough — the illness is in the center. The Emperor said: When the autumn pulse is too much or not enough, what are the illnesses in each case? Qi Bo said: Too much makes a person have reverse qi and pain in the back, oppressed, oppressed. Not enough makes a person pant, with little qi in the breath and coughing; qi rises and blood is seen, and below one hears the sounds of illness. The Emperor said: Good. The winter pulse is like an encampment. How is it an encampment? Qi Bo said: The winter pulse is the kidney, the water of the north, that by which the ten thousand things join and store. Therefore its qi comes sunken and beating — hence it is called encampment. The reverse of this is illness. The Emperor said: How is it the reverse? Qi Bo said: If its qi comes like a flicked stone, this is called too much — the illness is on the outside. If it leaves as if rapid, this is called not enough — the illness is in the center. The Emperor said: When the winter pulse is too much or not enough, what are the illnesses in each case? Qi Bo said: Too much makes a person slack and weary, with pain along the spine-pulse, little qi, and no wish to speak. Not enough makes a person feel the heart hanging as if ill with hunger; the flanks are clear-cold; there is pain in the spine, fullness in the lesser abdomen, and change in the urine. The Emperor said: Good. The Emperor said: The order of the four seasons, and the variations of against and with — yet what does the spleen pulse alone govern? Qi Bo said: The spleen pulse is earth, the orphan zang that irrigates the four sides. The Emperor said: Then can the good and the ill of the spleen be seen? Qi Bo said: The good cannot be seen; the ill can be seen. The Emperor said: How can the ill be seen? Qi Bo said: If it comes like flowing water, this is called too much — the illness is on the outside. If it is like a bird's beak, this is called not enough — the illness is in the center. The Emperor said: You, Master, say the spleen is the orphan zang, the earth of the center that irrigates the four sides. When it is too much or not enough, what are the illnesses in each case? Qi Bo said: Too much makes a person unable to raise the four limbs. Not enough makes the nine orifices not communicate. It is called doubled stiffness. The Emperor started up, startled, bowed twice and touched his head to the ground, and said: Good. I have obtained the great essentials of the pulse. The utmost numbers under heaven, the five colors and the changes of the pulse, measuring and the extraordinary and the constant — the Dao lies in the one. The spirit turns and does not reverse; if it reverses it does not turn, and the mechanism is lost. The essentials of the utmost numbers press near to the subtle. Write them on the jade tablet; store them in the zang and fu; read them every dawn. Call it the jade mechanism. The five zang receive qi from that which they generate, transmit it to that which they overcome, lodge qi in that which generates them, and die in that which they do not overcome. When an illness is about to die, it must first travel to that which it does not overcome, and then the illness dies. This speaks of qi running against — therefore death. The liver receives qi from the heart, transmits it to the spleen, lodges qi in the kidney, and dies on reaching the lung. The heart receives qi from the spleen, transmits it to the lung, lodges qi in the liver, and dies on reaching the kidney. The spleen receives qi from the lung, transmits it to the kidney, lodges qi in the heart, and dies on reaching the liver. The lung receives qi from the kidney, transmits it to the liver, lodges qi in the spleen, and dies on reaching the heart. The kidney receives qi from the liver, transmits it to the heart, lodges qi in the lung, and dies on reaching the spleen. These are all deaths by going against. Divide day and night into five; this is how one reads the earliness or lateness of death and life. The Yellow Emperor said: The five zang communicate; their moving has an order. When the five zang have illness, each transmits to that which it overcomes. If it is not treated, by the law of three months or six months, or of three days or six days, it transmits through the five zang and then there must be death — this is the following order of transmitting to that which is overcome. Therefore it is said: those who can distinguish in yang know where the illness came from; those who can distinguish in yin know the date of death and life. This means: know that it dies on reaching the place where it is trapped. Therefore wind is the eldest of the hundred illnesses. When wind and cold now lodge in a person, they make the fine hairs stand straight; the skin closes and there is heat. At such a time it can be issued by sweat. Or there is impediment, no feeling, swelling and pain — at such a time it can be removed by hot decoctions and compresses, and by fire, moxa, and needling. If it is not treated, the illness enters and lodges in the lung; it is called lung impediment, and issues as coughing and rising qi. If it is not treated, the lung then transmits it and sets it in motion in the liver; the illness is called liver impediment, also called reversal; there is pain in the flanks and food comes back out. At such a time one may press or needle. If it is not treated, the liver transmits it to the spleen; the illness is called spleen-wind, and issues as dan, heat in the abdomen, a troubled heart, and yellow coming out. At such a time one may press, may use medicines, may bathe. If it is not treated, the spleen transmits it to the kidney; the illness is called shan-jia; the lesser abdomen is wronged by heat and in pain, and white comes out. It is also called gu. At such a time one may press, may use medicines. If it is not treated, the kidney transmits it to the heart; the sinews and vessels pull upon one another and grow taut; the illness is called spasms. At such a time one may use moxa, may use medicines. If it is not treated, when ten days are full, by the law there must be death. If the kidney thereby transmits it to the heart, and the heart then turns and transmits it back and sets it in motion in the lung, cold and heat issue; by the law there must be death in three years. This is the order of the illness. Yet those that arise suddenly need not be treated by the transmission. Or the transmission and change do not follow the order. Those that do not enter by the order — worry, fear, grief, joy, anger — make it so that the order cannot be kept, and therefore a person has a great illness. Thus if joy is great and there is great vacuity, kidney-qi takes the place; if there is anger, liver-qi takes the place; if there is grief, lung-qi takes the place; if there is fear, spleen-qi takes the place; if there is worry, heart-qi takes the place. This is their Dao. Therefore illnesses are five; five times five is twenty-five changes, and then their transmissions and transformations. To transmit is another name for taking the place. When the great bones are withered and dry, the great flesh sunken, the chest full of qi, panting without ease, and the qi moves the form — the term is death in six months. When the true-zang pulse appears, then give the appointed day. When the great bones are withered and dry, the great flesh sunken, the chest full of qi, panting without ease, and inner pain draws to the shoulders and nape — the term is death in one month. When the true zang appears, then give the appointed day. When the great bones are withered and dry, the great flesh sunken, the chest full of qi, panting without ease, inner pain draws to the shoulders and nape, the body is hot, the flesh deserts, and the joints are broken — when the true zang appears, death within ten months. When the great bones are withered and dry, the great flesh sunken, the shoulder-marrow wasting within, and movement growing more feeble — if the true zang has not yet appeared, the term is death in one zang; when its true zang is seen, then give the appointed day. When the great bones are withered and dry, the great flesh sunken, the chest full of qi, pain inside the abdomen, the heart not at ease, heat in the shoulders, nape, and body, the joints broken and the flesh deserted, the eye-sockets sunken — when the true zang appears and the eyes do not see people, death at once; if they still see people, death comes at the time of that which is not overcome. Sudden vacuity arriving all at once in the body: the five zang are cut off and closed, the pulse-roads do not communicate, qi does not come and go — it is like a fall or a drowning; no term can be made. If the pulse is cut off and does not come, or if in one breath of a person it arrives five or six times, even if the form and flesh have not deserted, and even if the true zang is not seen — still there is death. When the true liver pulse arrives, urgent within and without, like following a knife-edge, cutting, cutting, like pressing the string of a qin or se; the color is green-white without sheen; the hair breaks — then death. When the true heart pulse arrives, firm and beating, like following job's-tears seeds, linked, linked; the color is red-black without sheen; the hair breaks — then death. When the true lung pulse arrives, large and empty, like a feather striking a person's skin; the color is white-red without sheen; the hair breaks — then death. When the true kidney pulse arrives, beating and cut off, like a finger flicking a stone, click, click; the color is black-yellow without sheen; the hair breaks — then death. When the true spleen pulse arrives, weak and suddenly rapid, suddenly sparse; the color is yellow-green without sheen; the hair breaks — then death. Whenever a true-zang pulse appears, all are death; they are not treated. The Yellow Emperor said: When the true zang is seen it is called death. Why? Qi Bo said: The five zang all receive qi from the stomach. The stomach is the root of the five zang. The qi of the zang cannot of itself reach the hand-taiyin; it must rely on stomach-qi, and only then reach the hand-taiyin. Therefore each of the five zang, in its own time, arrives of itself at the hand-taiyin. When pathogenic qi prevails, jing-qi declines. Therefore when the illness is severe, stomach-qi cannot arrive together with it at the hand-taiyin, and so the qi of the true zang is seen alone. What is seen alone is the illness prevailing over the zang; therefore it is called death. The Emperor said: Good. The Yellow Emperor said: In treating any illness, examine the form, the qi, the color and its sheen, the flourishing and decline of the pulse, the newness or age of the illness — then treat, and do not come after its time. When form and qi obtain one another, it is called treatable. When the color's sheen is floating, it is called easy to end. When the pulse follows the four seasons, it is called treatable. A pulse that is weak and slippery has stomach-qi; it is named easy to treat — take it in its time. When form and qi lose one another, it is called hard to treat. When the color is withered and without sheen, it is called hard to end. A pulse that is replete and firm is called growing more severe. A pulse that goes against the four seasons is not to be treated. One must examine the four difficulties, and make them clearly known. What is called going against the four seasons: obtaining a lung pulse in spring, a kidney pulse in summer, a heart pulse in autumn, a spleen pulse in winter — and if what arrives is in every case hanging, cut off, sunken, and rough — this is named going against the four seasons. Before the form of a zang has appeared: in spring and summer a pulse that is sunken and rough, in autumn and winter a pulse that is floating and large — this is named going against the four seasons. Heat illness with a quiet pulse; draining with a large pulse; blood desertion with a replete pulse; illness in the center with a pulse replete and firm; illness on the outside with a pulse not replete and firm — all are hard to treat. The Yellow Emperor said: I have heard that vacuity and repletion are used to decide death and life. I wish to hear the condition. Qi Bo said: The five repletions, death. The five vacuities, death. The Emperor said: I wish to hear of the five repletions and the five vacuities. Qi Bo said: An abundant pulse, hot skin, a swollen abdomen, no communication before and behind, and oppression with dimness — these are called the five repletions. A fine pulse, cold skin, little qi, draining and disinhibition before and behind, and drink and food not entering — these are called the five vacuities. The Emperor said: At times there are those who live. Why? Qi Bo said: If thin gruel enters the stomach and the pouring drain stops, the vacuous one lives. If the body sweats and one obtains a later disinhibition, the replete one lives. These are the signs.

The line

The Yellow Emperor asked: The spring pulse is like a string. How is it a string?

The note

When the true-zang pulse appears, the root is already showing. The jade mechanism asks how the pulses of the four seasons resemble the growing of the ten thousand things — not how to take a pulse and "get it right."