Suwen · On Impediment

The text

The Yellow Emperor asked: How is impediment born? Qi Bo answered: The three qi of wind, cold, and damp arrive mixed, and join to become impediment. When the wind qi prevails, it is wandering impediment. When the cold qi prevails, it is painful impediment. When the damp qi prevails, it is lodged impediment. The Emperor said: There are five of them. How is that? Qi Bo said: Meeting this in winter, it is bone impediment. Meeting this in spring, it is sinew impediment. Meeting this in summer, it is vessel impediment. Meeting this in the season of utmost yin, it is flesh impediment. Meeting this in autumn, it is skin impediment. The Emperor said: It lodges inward in the five zang and the six fu. What qi makes this so? Qi Bo said: Each of the five zang has that with which it pairs. When the illness is long and does not leave, it lodges inward in its pair. Thus if bone impediment is not done, and one is again affected by what is irregular, it lodges inward in the kidney. If sinew impediment is not done, and one is again affected by what is irregular, it lodges inward in the liver. If vessel impediment is not done, and one is again affected by what is irregular, it lodges inward in the heart. If flesh impediment is not done, and one is again affected by what is irregular, it lodges inward in the spleen. If skin impediment is not done, and one is again affected by what is irregular, it lodges inward in the lung. What is called impediment: each, in its own season, is again affected by the qi of wind, cold, and damp. Of all impediment that visits the five zang: in lung impediment there is vexation, fullness, panting, and vomiting. In heart impediment the vessels are not open; with vexation the heart below drums; qi rises suddenly and there is panting; the throat is dry, given to belching; when reversing qi rises, there is fear. In liver impediment one is startled when lying at night; one drinks much and urinates often; above there is a pulling as if one were carrying a child. In kidney impediment one is given to distention; the sacrum is used in place of the heel, the spine in place of the head. In spleen impediment the four limbs slacken and fall; cough arises, juice is vomited; above there is a great block. In intestinal impediment one drinks often and what enters cannot come out; the qi of the center pants and contends; at times undigested outflow arises. In bladder impediment, in the lesser abdomen and the bladder, pressing inward there is pain, as if scalded with hot water; urination is rough; above there is clear snivel. As for yin qi: when it is still, the spirit is stored; when it is restless, the spirit is melted away. When food and drink are doubled of themselves, the intestines and stomach are wounded. Overflowing qi that pants: impediment gathers in the lung. Overflowing qi of worry and thought: impediment gathers in the heart. Overflowing qi that loses urine: impediment gathers in the kidney. Overflowing qi of exhaustion: impediment gathers in the liver. Overflowing qi that cuts off the flesh: impediment gathers in the spleen. All impediment that is not done also grows inward. When the wind qi prevails, that person is easily finished. The Emperor said: In impediment, there are at times those who die, those whose pain lasts long, and those who are easily finished. What is the reason? Qi Bo said: What has entered the zang dies. What lingers between the sinews and bones hurts for a long time. What lingers between the skin is easily finished. The Emperor said: When it visits the six fu, how is that? Qi Bo said: Here too food and drink and the place one lives are the root of the illness. The six fu also each have transport points. When the qi of wind, cold, and damp strikes those transport points, and food and drink answer it, it follows the transport points inward and each lodges in its fu. The Emperor said: How does one treat it with the needle? Qi Bo said: The five zang have transport points; the six fu have uniting points. Following the divisions of the vessels, each has where it arises. Follow each at its crossing, and the illness is healed. The Emperor said: Can the qi of ying and wei also make a person have impediment? Qi Bo said: Ying is the jing-qi of water and grain. It is harmonized and regulated in the five zang, sprinkled and set out in the six fu, and only then can it enter the vessels. Thus it follows the vessels up and down, threads the five zang and networks the six fu. Wei is the fierce qi of water and grain. Its qi is swift, slippery, and keen; it cannot enter the vessels. Thus it follows within the skin, in the spaces where the flesh divides, steams the membranes of the gao, and scatters in the chest and abdomen. When its qi is reversed, there is illness; when one follows its qi, there is recovery. It does not join with the qi of wind, cold, and damp, and so it does not become impediment. The Emperor said: Good. Impediment may hurt, or not hurt, or be without feeling; it may be cold, or hot, or dry, or damp. What is the reason? Qi Bo said: Where there is pain, the cold qi is much. There is cold, therefore there is pain. Where there is no pain and no feeling, the illness has been long and has entered deep; the travel of ying and wei is rough; the channels and networks are at times sparse, and so they are not open; the skin is not nourished, and so it is without feeling. Where there is cold, yang qi is little and yin qi is much; they add to the illness, and so there is cold. Where there is heat, yang qi is much and yin qi is little; the qi of the illness prevails, yang meets yin, and so there is impediment-heat. Where there is much sweat and dampness, this is meeting damp in the extreme. Yang qi is little, yin qi is full; the two qi affect each other, and so sweat comes out and there is dampness. The Emperor said: When impediment is the illness and there is no pain — how is that? Qi Bo said: Impediment in the bone is heaviness. In the vessels, the blood congeals and does not flow. In the sinews, one bends and does not extend. In the flesh, there is no feeling. In the skin, there is cold. When these five are all present, there is no pain. Of all that is of the kind of impediment: meeting cold, it crawls; meeting heat, it slackens. The Emperor said: Good.

The line

Qi Bo answered: The three qi of wind, cold, and damp arrive mixed, and join to become impediment.

The note

Three qi arrive mixed and join to become impediment. The joining is the point. Cold alone or damp alone is not yet called impediment. Impediment is several runnings tangled as one.