Suwen · On Reversal

The text

The Yellow Emperor asked: Of reversal, the cold and the hot — how is that? Qi Bo answered: When yang qi declines below, it becomes cold reversal. When yin qi declines below, it becomes heat reversal. The Emperor said: That heat reversal is heat, and that it must arise from beneath the feet — how is that? Qi Bo said: Yang qi arises on the outer side of the five toes. The yin vessels gather beneath the feet and collect in the heart of the foot. Thus when yang qi is full, there is heat beneath the feet. The Emperor said: That cold reversal is cold, and that it must go from the five toes up to the knee — how is that? Qi Bo said: Yin qi arises on the inner side of the five toes, gathers below the knee and collects above the knee. Thus when yin qi is full, there is cold from the five toes to above the knee. This cold does not come from outside; it all comes from within. The Emperor said: What has cold reversal lost, that it is so? Qi Bo said: The front yin is where the ancestral sinew gathers, where Taiyin and Yangming meet. In spring and summer, yang qi is much and yin qi is little; in autumn and winter, yin qi is full and yang qi declines. This person is of a strong constitution; in autumn and winter he is robbed by what he uses. The qi below contends upward and cannot be restored; jing-qi overflows downward, and the irregular qi follows it upward. Qi is caused from the center; yang qi declines and cannot soak and nourish its channels and networks. Yang qi is harmed day by day; yin qi alone remains. Thus the hands and feet are cold from it. The Emperor said: How does heat reversal come to be so? Qi Bo said: When wine enters the stomach, the network vessels are full and the channel vessels are vacuous. The spleen governs moving the fluids of the stomach. When yin qi is vacuous, yang qi enters; when yang qi enters, the stomach is not in harmony; when the stomach is not in harmony, jing-qi is exhausted; when jing-qi is exhausted, it does not nourish the four limbs. This person must often be drunk, or enter the chamber when full. Qi gathers in the spleen and cannot scatter. The qi of wine and the qi of grain clash; heat is full in the center; thus heat leans to one side of the body, there is inner heat, and the urine is red. The qi of wine is full and fierce; the kidney qi has declined; yang qi alone is full. Thus the hands and feet are hot from it. The Emperor said: Reversal may make a person's abdomen full, or make a person suddenly not know others, or only after half a day, even a whole day, come to know others again. How is that? Qi Bo said: When yin qi is full above, the below is vacuous; when the below is vacuous, the abdomen swells and is full. When yang qi is full above, the qi below piles upward and the irregular qi reverses; when it reverses, yang qi is in disorder; when yang qi is in disorder, one does not know others. The Emperor said: Good. I wish to hear the forms of reversal in the six channel vessels, and how the illnesses appear. Qi Bo said: Reversal of the Great Yang: the head swells and is heavy; the feet cannot walk; it arises as dizziness and falling. Reversal of the Yangming: withdrawal illness; one wants to run and shout; the abdomen is full, one cannot lie down; the face is red and hot; one sees what is not there and speaks what is not so. Reversal of the Shaoyang: sudden deafness; the cheeks swell and are hot; the flanks hurt; the shin cannot be moved. Reversal of the Taiyin: the abdomen is full and swollen; what comes after is not free; one does not want food; if one eats, one vomits and cannot lie down. Reversal of the Shaoyin: the mouth is dry, the urine red; the abdomen is full, the heart hurts. Reversal of the Jueyin: the lesser abdomen swells and hurts; the abdomen distends; the fluids of stool and urine are not free; one likes to lie with the knees bent; the yin shrinks and swells; heat inside the shin. When it is full, drain it; when it is vacuous, fill it; when it is neither full nor vacuous, take it from the channel. Taiyin reversal against the current: the shin tightens in spasm; heart pain pulling the abdomen. Treat what governs the illness. Shaoyin reversal against the current: vacuous fullness, vomiting and change; clear outflow below. Treat what governs the illness. Jueyin reversal against the current: spasm and lumbar pain; vacuous fullness; the front is closed; delirious speech. Treat what governs the illness. When the three yin all reverse, stool and urine will not come; the hands and feet are made cold; in three days, death. Taiyang reversal against the current: falling rigid, vomiting blood, given to nosebleed. Treat what governs the illness. Shaoyang reversal against the current: the hinges are not free; when the hinges are not free, the lumbar region cannot walk, the nape cannot turn to look; if intestinal abscess arises it cannot be treated; if there is fright, death. Yangming reversal against the current: panting, cough, the body hot, given to fright, nosebleed, vomiting blood. Hand Taiyin reversal against the current: vacuous fullness and cough, given to vomiting foam. Treat what governs the illness. Hand Heart-Governor and Shaoyin reversal against the current: heart pain pulling the throat, the body hot — death, it cannot be treated. Hand Taiyang reversal against the current: the ears are deaf, tears come out; the nape cannot turn to look; the lumbar region cannot bow or look up. Treat what governs the illness. Hand Yangming and Shaoyang reversal against the current: throat impediment arises; the throat swells and there is tugging. Treat what governs the illness.

The line

Qi Bo answered: When yang qi declines below, it becomes cold reversal. When yin qi declines below, it becomes heat reversal.

The note

Yin and yang first decline below; only then is reversal seen in the hands and feet. Cold reversal and heat reversal have their root below and their flower in the limbs. Do not argue only with the hands and feet.