Suwen · On Being Out of Tune

The text

The Yellow Emperor asked: A person's body is not unusually warm, not unusually hot — and yet there is heat and vexed fullness. Why? Qi Bo answered: Yin qi is little and yang qi prevails; therefore there is heat and vexed fullness. The Emperor said: A person is not wearing cold clothes, and there is no cold qi in the center — yet cold is born from the center. Why? Qi Bo said: This person has much impediment-qi. Yang qi is little, yin qi is much; therefore the body is cold as if coming out of water. The Emperor said: A person has heat in the four limbs; meeting wind and cold, it is as if roasted, as if on fire. Why? Qi Bo said: In this person yin qi is vacant and yang qi is abundant. The four limbs are yang. Two yangs obtain each other, and yin qi is vacant and little. Little water cannot put out abundant fire, and yang governs alone. What governs alone cannot give birth and growth. It only prevails, and then stops. Meeting wind and being as if moxaed, as if on fire — this person will have the flesh melted. The Emperor said: A person has a cold body; hot water and fire cannot heat it, thick clothes cannot warm it, and yet they do not freeze and shiver. What illness is this? Qi Bo said: This person has, from the first, prevailing kidney qi, and takes water as their work. Taiyang qi has declined; the kidney fat is withered and does not grow. One water cannot prevail over two fires. The kidney is water, and is born in the bones. If the kidney does not give birth, the marrow cannot fill; therefore the cold reaches even the bone. That they cannot freeze and shiver: the liver is one yang, the heart is two yang, the kidney is the solitary zang. One water cannot prevail over two fires; therefore they cannot freeze and shiver. The illness is named bone impediment. This person will have contracted joints. The Emperor said: A person whose flesh is numb: even near clothes and wadding, it is still numb. What illness is this called? Qi Bo said: Ying qi is vacant, wei qi replete. When ying qi is vacant, there is no feeling; when wei qi is vacant, there is no use. When ying and wei are both vacant, there is no feeling and also no use; the flesh is as it was. When the person's body and the will do not have each other, it is called death. The Emperor said: Some have qi going against its course, cannot lie down, and the breath has a sound; some cannot lie down, and the breath has no sound; some rise and rest as usual, yet the breath has a sound; some can lie down and walk, yet pant; some cannot lie down, cannot walk, and pant; some cannot lie down, and lying, pant. Which zang makes each of these so? I wish to hear the reason. Qi Bo said: Those who cannot lie down, and whose breath has a sound — this is Yangming going against its course. The three yang of the foot travel downward; now they go against and travel upward; therefore the breath has a sound. Yangming is the stomach vessel. The stomach is the sea of the six fu; its qi also travels downward. When Yangming goes against and cannot follow its road, one cannot lie down. The Lower Classic says: when the stomach is not in accord, lying is not at rest. This is what is meant. Those who rise and rest as usual, yet whose breath has a sound — this is the collateral vessel of the lung going against. The collateral cannot follow the channel up and down; therefore it stays in the channel and does not travel. Illness of a collateral vessel is slight in the person; therefore they rise and rest as usual, yet the breath has a sound. Those who cannot lie down, and who pant when they lie — this is water-qi lodging as a guest. Water follows the fluids and flows. The kidney is the water zang; it governs the fluids; it governs lying and panting. The Emperor said: Good.

The line

The Lower Classic says: when the stomach is not in accord, lying is not at rest.

The note

Being out of tune means the body's seasons have reversed. When the stomach is not in accord, lying is not at rest — sleeplessness is sometimes first a disorder of the central earth, not a matter of the night.