Introduction to the Huangdi Neijing
1. What is the Huangdi Neijing?The “Han Shu: Yi Wen Zhi: Fang Ji Lue” records four types of TCM classics: medical texts, classic formulas, immortality texts, and sexual health texts.Among them, the medical texts include: “Huangdi Neijing” (The Yellow Emperor’s Inner Canon) with eighteen volumes, “Wai Jing” (Outer Canon) with thirty-seven volumes; “Bian Que Neijing” (The Inner Canon of Bian Que) with nine volumes, “Wai Jing” with twelve volumes; “Bai Shi Neijing” (The Inner Canon of Bai) with thirty-eight volumes, “Wai Jing” with thirty-six volumes; and “Pang Pian” (Miscellaneous Chapters) with twenty-five volumes.Except for the “Huangdi Neijing”, all other medical texts have been lost. Therefore, the “Huangdi Neijing” has become the earliest existing classic of TCM. What is a medical text? The “Han Shu: Yi Wen Zhi: Fang Ji Lue” states: “Medical texts are based on human blood vessels, meridians, bone marrow, yin and yang, and the exterior and interior, to elucidate the root of all diseases, the distinction between life and death, and to apply appropriate acupuncture, decoctions, and herbal formulas. The best remedies function like a magnet attracting iron, achieving immediate results. Incompetent practitioners violate medical principles, causing those who should recover to worsen, and those who should live to die.” In short, medical texts are works that elucidate the physiological, pathological, diagnostic, therapeutic, and preventive theories of medicine. They are called “classics” because they are important. In ancient times, books with certain rules and that must be learned were referred to as “classics”, such as the Confucian “Six Classics”, Laozi’s “Dao De Jing”, and the simpler “Three Character Classic”. Therefore, it is called “Neijing” not because, as Wu Kun’s “Su Wen Zhu” or Wang Jiuda’s “Neijing He Lei” states, it refers to the “five internal yin and yang”, nor as Zhang Jiebin’s “Lei Jing” states, “the internal is the way of life”, but merely as a contrast to the “external”.This is similar to the “Han Shi Nei Zhuan” and “Han Shi Wai Zhuan”, “Chun Qiu Nei Zhuan” and “Chun Qiu Wai Zhuan”, as well as the “Inner Chapters” and “Outer Chapters” of “Zhuangzi”, and the “Inner Store” and “Outer Store” of “Han Feizi”. The “Huangdi Neijing” and the classics of Bian Que and Bai are simply no longer available.2. The Era of the Huangdi Neijing’s CompilationFirst, it should be pointed out that the “Huangdi Neijing” was certainly not written by the Yellow Emperor; it is purely a later attribution. As pointed out in “Huainanzi: Xiu Wu Xun”: “Common people often revere the ancient and despise the present, so those who speak of the Dao must attribute it to Shennong or the Yellow Emperor to be accepted.” The name “Yellow Emperor” is intended to trace back to the origins and to illustrate that the culture of Chinese medicine has a very early origin.When exactly was the “Huangdi Neijing” compiled? Scholars such as Song Lin Yi and Gao Bao Heng believe: “Who can know if not a great sage? The people of the Warring States have no relation to it. The great “Huangdi Neijing” with eighteen volumes and the “Zhen Jing” with three volumes are from ancient times”; Shao Yong believes: “The “Su Wen” and “Yin Fu” are texts from the time of the Seven States”; Cheng Hao believes: “The “Su Wen” was written at the end of the Warring States”; Sima Guang believes: “If one claims the “Su Wen” is truly the work of the Yellow Emperor, it may not be so. The Yellow Emperor also governed the world; how could he sit in the Ming Hall all day discussing medicine and acupuncture with Qi Bo? This was the reliance of physicians between the Zhou and Han dynasties to obtain the teachings of Zhong Er”; Zhu Xi also believes: “By the time of the Warring States, practitioners of the arts began to write them down for transmission, as cited by Liezi and the “Su Wen”, “Wo Qi” and others…”; Ming scholar Fang Xiaoru believes: “All are from the Warring States, Qin, and Han people”; Fang Yizhi believes: “To maintain their profession and gradually expand it, the “Ling Shu” and “Su Wen” were all written at the end of the Zhou”. Qing scholar Wei Litong believes: “The books of Xuanqi are similar to those of the Spring and Autumn period, but attributed to ancient times”. In summary, it is more credible to date the compilation of the “Huangdi Neijing” to the Warring States period, but it cannot be assumed that all eighty-one chapters of the “Su Wen” and “Ling Shu” originated from the Warring States. Lü Fu has made a fair observation on this: “The “Neijing Su Wen” is known as the book of questions and answers between the Yellow Emperor and Qi Bo, and upon examining its intent, it is likely not the work of a single time, nor is it written by a single person. Liu Xiang attributed it to the sons of Han, and Chengzi said it was from the end of the Warring States, and its general outline is similar to the “Liji” compiled by Han Confucians and transmitted alongside the words of Confucius and Zisi.” The above is merely a summary analysis based on the views of most scholars. In fact, the majority of the chapters of the “Huangdi Neijing” (i.e., the main part of the “Huangdi Neijing”) can be argued to have been composed during the Warring States period. Due to space limitations, this discussion will be omitted.For the few chapters composed after the Warring States, the following explanations must be made: The seventh volume of the “Su Wen” has long been lost, and Tang Wang Bing supplemented it with the secret text of his master Zhang Gong, adding the “Tian Yuan Ji Da Lun”, “Wu Yun Xing Da Lun”, “Liu Wei Zhi Da Lun”, “Qi Jiao Bian Da Lun”, “Wu Chang Zheng Da Lun”, “Liu Yuan Zheng Ji Da Lun”, and “Zhi Zhen Yao Da Lun”, which are actually another medical text, the “Yin Yang Da Lun”. By its use of the Jiazi calendar, it can be determined that it must have been promulgated after the second year of the Eastern Han Emperor Zhang’s Yuanhe (85 AD) when the Four Division Calendar was issued. Since it was cited by Zhang Zhongjing in his “Shang Han Za Bing Lun”, it must have been before Zhang Zhongjing’s time.Some chapters in the “Ling Shu” were also written later, such as the “Yin Yang Xi Ri Yue Pian”, which contains the phrase “Yin is the birth of Yang in the first month”, thus it can be determined to have been composed after the promulgation of the Taichu Calendar in the first year of Emperor Wu of Han (100 BC).The seventy-second chapter of the “Su Wen”, “Ci Fa Lun”, and the seventy-third chapter, “Ben Bing Lun”, were already lost when Wang Bing annotated the “Su Wen”, but were included as “Su Wen Yi Pian” by Song scholar Liu Wenshu in his work “Su Wen Ru Shi Yun Qi Lun”. Therefore, it can be assumed that these two chapters were likely forgeries from the Tang and Song periods.In summary, the “Huangdi Neijing” was not the work of a single person, and its writing should be placed in the Warring States period, with a few individual chapters composed during the Han dynasty. As for the supplements by Wang Bing and the additions by Liu Wenshu, they should not be regarded as part of the text of the “Huangdi Neijing”, but it is also acceptable to retain them as per convention.3. The Titles and Transmission of the Su Wen and Ling ShuThe name “Su Wen” first appeared in Zhang Zhongjing’s “Shang Han Za Bing Lun: Self-Introduction”. He stated: “I have compiled the “Su Wen”, “Jiu Juan”, “Eighty-One Difficulties”, “Yin Yang Da Lun”, “Tai Lu”, and “Yao Lu”.”For over 1700 years, the name “Su Wen” has remained unchanged. Why is it called “Su Wen”? Lin Yi, Gao Bao Heng, and others in their “New Collation” say: “The meaning of the name “Su Wen” is that ‘Su’ refers to the origin, and ‘Wen’ refers to the Yellow Emperor asking Qi Bo. It presents the source of nature and the foundation of the five elements, hence it is called ‘Su Wen’.’ Although Yuan Qi has this explanation, the meaning is not very clear. According to “Qian Zuo Du”, it states: ‘All forms arise from the formless, hence there is Tai Yi, Tai Chu, Tai Shi, and Tai Su. Tai Yi is the unseen Qi; Tai Chu is the beginning of Qi; Tai Shi is the beginning of form; Tai Su is the beginning of quality.’ Qi, form, and quality are present, and diseases arise from this. Therefore, the Yellow Emperor inquired about the origin of this Tai Su quality. The name “Su Wen” may derive from this.” Humans are living beings composed of Qi, form, and quality, and it is inevitable that various diseases will occur, both minor and major, hence the inquiry format is used to elucidate this, which is the original meaning of “Su Wen”. Sui scholar Yang Shangshan organized the “Neijing” and directly referred to it as “Huangdi Neijing Tai Su”, which is quite insightful.The “Ling Shu” was originally called the “Zhen Jing”. The first chapter of the “Ling Shu”, “Jiu Zhen Shi Yuan”, contains the phrase “First establish the ‘Zhen Jing'”, which is undoubtedly a self-introduction. Later, it was also referred to as “Jiu Juan” (as seen in Zhang Zhongjing’s “Shang Han Lun” preface), and Jin scholar Huang Fu Mi further referred to it as the “Zhen Jing”. Subsequently, it was known as “Jiu Xu” (as seen in the “Goryeo History”, “Song Zhi”, and Lin Yi’s cited texts), “Jiu Ling” (as seen in the “Sui Zhi”, “Tang Zhi”, “Song Zhi”, etc.), and “Huangdi Zhen Jing” (as seen in the “Qi Lu”, “Sui Zhi”, “Tang Zhi”, and historical texts of Silla and Goryeo). The name “Ling Shu” first appeared in Wang Bing’s preface to the “Su Wen” and in his annotations of the “Su Wen”. Wang Bing, while annotating the “Su Wen”, quoted the phrase “The meridians are the interior, and those that branch and cross are the collaterals; the branches of the collaterals are the Sun Luo” twice, indicating that the “Ling Shu” is indeed the “Zhen Jing”. Furthermore, other annotations of the “Su Wen” that quote the “Zhen Jing” are all texts from the “Ling Shu”, further proving this point.The evolution of the name “Ling Shu” is roughly as follows, and its naming significance requires specific analysis. Since the book primarily studies acupuncture issues, it is called the “Zhen Jing”; since it consists of nine volumes, it is named “Jiu Juan”, and thus there are names like “Jiu Ling” and “Jiu Xu”. Why is it called “Ling Shu”? Ma Hong said: “The ‘Ling Shu’ is precisely because the pivot is the portal that connects the opening and closing, and ‘Ling’ refers to the divine and mysterious. The essence of this book is how it differs from this.”Zhang Jiebin succinctly stated: “The key to the divine and spiritual is called ‘Ling Shu’.” These interpretations are all based on the profoundness of the pivot mechanism.The “Su Wen” has maintained its nine-volume structure from the Warring States period until the time of Qi Liang when Yuan Qi wrote the “Su Wen Xun Jie”. However, by the time Yuan Qi annotated the “Su Wen”, the seventh volume had already been lost.Wang Bing believed it was due to “fear of misattribution, hence the seventh volume was hidden by the Shi family”. Wang Bing claimed to have obtained the secret text of his master Zhang Gong, and thus compiled annotations to ensure its immortality, combining the old volumes with the eighty-one chapters into twenty-four volumes. This is how the “Huangdi Neijing Su Wen” that exists today came to be. Of course, there are also the twelve-volume editions published by the Hu family of the Yuan dynasty and the fifty-volume edition from the Ming dynasty during the Zheng Tong period, but their content and chapter order have not changed, remaining as Wang Bing’s original work.As for the “Ling Shu”, although there are several transmission systems such as “Jiu Juan”, “Jiu Xu”, “Jiu Ling”, and “Zhen Jing”, they have all been lost after the Sui and Tang dynasties. When Song officials Lin Yi, Gao Bao Heng, and others were correcting medical texts, they found it too incomplete to be corrected. The “Ling Shu Jing” presented by Song historian Shi Song, although different in content from the “Ling Shu” quoted by Wang Bing and the “Ling Shu” quoted by Wang Yi, is still the only version that exists today. Shi Song’s reason for changing the “Ling Shu” to twenty-four volumes was merely to match the number of volumes of Wang Bing’s annotated “Su Wen” without any deeper meaning. Because originally, both of these books were nine volumes, and now they have both become twenty-four volumes.In summary, the twenty-four-volume version of the “Su Wen” annotated by Wang Bing is the earliest existing version, and it has been corrected by the Medical Book Correction Bureau of the Northern Song dynasty. The twenty-four-volume version of the “Ling Shu” compiled by Shi Song is also the earliest and only version that exists today.4. The Huangdi Neijing is the Great Achievement of Medicine Before the Warring States PeriodAs mentioned earlier, the “Huangdi Neijing” is neither a work of a single time nor the product of a single author, but rather a summary of many medical writings before the Warring States period. This can be proven not only by the fact that both the “Su Wen” and “Ling Shu” each have eighty-one chapters, but also by the extensive citations of ancient literature in the “Huangdi Neijing” and the mutual references between the “Su Wen” and “Ling Shu”, as well as among the various chapters.The ancient literature cited in the “Huangdi Neijing” is approximately over fifty types, among which those with titles and whose content is mostly preserved include: “Ni Shun Wu Ti”, “Jin Fu”, “Mai Du”, “Ben Cang”, “Wai Chuan”, “Wu Se”, “Yu Ji”, “Jiu Zhen Zhi Lun”, “Re Lun”, “Zhen Jing”, “Zhong Shi”, “Jing Mai”, “Tian Yuan Ji”, “Qi Jiao Bian”, “Tian Yuan Zheng Ji”, “Zhen Jing”, etc. Sixteen types; those with only fragmentary texts include: “Ci Fa”, “Ben Bing”, “Ming Tang”, “Shang Jing”, “Xia Jing”, “Da Yao”, “Mai Fa”, “Mai Yao”, etc. Eight types; those with only titles include: “Kui Du”, “Qi Heng”, “Qi Heng Zhi Shi”, “Bi Lei”, “Jin Kui”, “Cong Rong”, “Wu Zhong”, “Wu Guo”, “Si De”, “Shang Xia Jing”, “Liu Shi Shou”, “Mai Bian”, “Jing Mai Shang Xia Pian”, “Shang Xia Pian”, “Zhen Lun”, “Yin Yang”, “Yin Yang Zhuan”, “Yin Yang Zhi Lun”, “Yin Yang Shi Er Guan Xiang Shi”, “Tai Shi Tian Yuan Ce”, “Tian Yuan Ce”, etc. Twenty-nine types. As for those that use phrases like “Jing Yan”, “Jing Lun”, “Lun Yan” or “Guo Yue…”, “Suo Wei…” to quote ancient literature, there are also many.It is precisely because of the above circumstances that we say the compilation of the “Huangdi Neijing” is the first summary of ancient Chinese medicine, and the “Huangdi Neijing” is the only surviving comprehensive work of medicine before the Warring States period.5. The Academic Thought of the Huangdi NeijingThe “Huangdi Neijing” adopts the ancient materialistic philosophy of the unity of Qi, viewing humans as part of the entire material world, with all things in the universe formed from the original substance “Qi”. Under the guiding concept of “humans correspond with heaven and earth” and “responding to the sun and moon”, it closely links humans with nature.All normal physiological activities and pathological changes in humans are closely related to the entire natural world. To further clarify this point, the following aspects will be elaborated:(1) “Qi” is the Origin of All Things in the UniverseAs Laozi said: “There is a thing that is mixed and formed, born before heaven and earth. Quiet and vast, standing alone and unchanging, circulating without end, it can be called the mother of the world; the Dao as a thing is elusive and indistinct; above it is not bright, below it is not dark; seen but not named, called ‘Yi’; heard but not named, called ‘Xi’; grasped but not obtained, called ‘Wei’.” This describes the original substance that constitutes the world—the metaphysical “Dao”. Song Yan and Yin Wen referred to this original substance as “Qi”. Influenced by these theories, the “Huangdi Neijing” also believes that “Qi” is the origin of all things in the universe. Before heaven and earth were formed, there was already Qi, filling the vast void and ceaselessly moving, and only then did the universe and all things come into being. As stated in the “Tian Yuan Ji Da Lun”: “I have accumulated (examined) the text of the ‘Tai Shi Tian Yuan Ce’ which states: ‘The vast void is the foundation of transformation, all things are initiated, and the five movements end in heaven. The true spirit of Qi is distributed, the nine stars hang bright, the seven luminaries revolve. There is yin and there is yang, there is soft and there is hard, the subtle and the obvious are in their places, cold and heat expand and contract, life and transformation occur, and all things flourish.'” This actually reveals the natural laws of celestial evolution and biological emergence. Before the formation of the universe, there was the vast void. Within the vast void, the original Qi was filled, and this Qi was the beginning of the transformation of heaven and earth. Due to the movement of Qi, the stars and planets were formed, the yin and yang of cold and heat emerged, and all things came into being. The movements of yin, yang, and the five elements govern the movements and changes of the earth and the emergence and development of all things.(2) The Relationship Between Humans and NatureThe “Huangdi Neijing” believes that humans and nature are closely related and correspond to each other. The movements and changes of the natural world constantly affect the human body. The “Su Wen: Bao Ming Quan Xing Lun” states: “Humans are born of the Qi of heaven and earth, and grow according to the laws of the four seasons.” This means that humans, like all things in the universe, are born of the Qi of heaven and earth and grow according to the laws of the four seasons. Therefore, the “Su Wen: Si Qi Diao Shen Da Lun” states: “The yin and yang of the four seasons are the root of all things. Therefore, sages nurture yang in spring and summer, and yin in autumn and winter, to follow their roots, thus synchronizing with the growth of all things. If one goes against their roots, it will harm their foundation and destroy their essence.” The “Su Wen: Yin Yang Ying Xiang Da Lun” also states: “Heaven has four seasons and five elements, to give birth, grow, store, and to create cold, heat, dryness, humidity, and wind; humans have five organs transforming into five Qi, giving rise to joy, anger, sadness, worry, and fear.” Humans exist between heaven and earth, and must rely on the movements and nourishment of the yin and yang Qi of heaven and earth to survive, just as the “Su Wen: Liu Jie Cang Xiang Lun” states: “Heaven nourishes humans with the five Qi, and earth nourishes humans with the five flavors. The five Qi enter through the nose, stored in the heart and lungs, making the five colors bright and the sounds clear. The five flavors enter through the mouth, stored in the intestines and stomach, with flavors stored to nourish the Qi of the five organs. When Qi harmonizes, life is born, and fluids are formed, and the spirit is born.”The internal environment of the human body must be coordinated and consistent with the external environment of nature. This requires humans to have a strong adaptability to nature. For example, the “Ling Shu: Wu Long Jin Ye Bie” states: “In hot weather, if one wears thick clothing, the pores open, causing sweating. In cold weather, the pores close, Qi and moisture do not circulate, and water remains in the bladder, leading to urination and Qi.”This is clearly an adaptation of water and fluid metabolism to the external environment. The pulse of humans manifests as spring, summer, autumn, and winter, which is also a response of the body’s Qi and blood to the different climatic changes of spring, summer, autumn, and winter, achieving coordination and unity with the external environment. If people violate the principles of nurturing life according to the seasons of spring growth, summer flourishing, autumn harvesting, and winter storing, they may develop diseases. As the “Su Wen: Si Qi Diao Shen Da Lun” states: “If one goes against the spring Qi, then Shao Yang does not grow, and liver Qi internally changes; if one goes against the summer Qi, then Tai Yang does not flourish, and heart Qi internally stagnates; if one goes against the autumn Qi, then Tai Yang does not store, and lung Qi becomes full; if one goes against the winter Qi, then Shao Yin does not store, and kidney Qi sinks alone.” This indicates that even within a single day, between day and night, the human body will also change in response to the rise and fall of the heavenly yang Qi. If one violates objective laws, they will also suffer harm. As the “Su Wen: Sheng Qi Tong Tian Lun” states: “Therefore, the yang Qi governs the external during the day; at dawn, human Qi is born; at noon, yang Qi is abundant; at dusk, yang Qi is depleted, and the Qi gates close. Therefore, at dusk, one should not disturb the muscles and bones, nor expose oneself to mist and dew; if one violates these three times, the body will become weak and thin.”This reciprocal relationship between humans and nature is evident throughout the “Huangdi Neijing”. Whether in physiology or pathology, whether in health preservation or in diagnosis and treatment, it cannot be separated from the guidance of this theory.(3) Humans are a Unity of Opposing Yin and YangHumans are a unity of opposing yin and yang, which is determined from the beginning of life. The “Su Wen: Sheng Qi Tong Tian Lun” states: “The origin of life is based on yin and yang.” The vital essence of life from the parents, which is the union of the yin and yang Qi, forms the living being. As stated in the “Ling Shu: Jue Qi”: “The two spirits clash and unite to form shape; this is called essence.” After the formation of the living being, the yin and yang Qi exist within it, mutually providing conditions for existence. They are interconnected, mutually nourishing, mutually transforming, and also mutually contending. As the “Su Wen: Yin Yang Ying Xiang Da Lun” states: “Yin is internal, and yang is its guardian; yang is external, and yin is its servant.” The “Su Wen: Sheng Qi Tong Tian Lun” states: “Yin is the essence stored and arises quickly, while yang is the defense of the external and solidifies.” These two statements succinctly explain the relationship of opposition and unity of yin and yang in the human body.From the perspective of the body’s organizational structure, the “Huangdi Neijing” views the human body as a unity of opposing yin and yang at various levels. The “Su Wen: Jin Kui Zhen Yan Lun” states: “In terms of the yin and yang of humans, the exterior is yang, and the interior is yin; in terms of the body’s yin and yang, the back is yang, and the abdomen is yin; in terms of the organs, the organs are yin, and the bowels are yang… Therefore, the back is yang, the heart is the yang within yin; the back is yang, the lung is the yin within yang; the abdomen is yin, the kidney is the yin within yin; the abdomen is yin, the spleen is the ultimate yin.” The “Huangdi Neijing” also divides each organ and bowel into yin and yang. Thus, at every level, whether in the whole or in parts, in organizational structure or physiological function, a unity of opposing yin and yang is formed, hence it is said that humans are a unity of opposing yin and yang.(4) The Human Body is a Coordinated Unity of the Five Major Systems: Liver, Heart, Spleen, Lung, and KidneyThe “five organs” referred to in the “Huangdi Neijing” actually refer to the five major systems centered around the liver, heart, spleen, lung, and kidney.Taking the heart as an example: The heart resides in the chest, is the sun among the yang, corresponds to the summer Qi, governs the spirit, governs the blood vessels, and is associated with the small intestine, producing blood and nourishing color, its manifestation is on the face, it stores the pulse, houses the spirit, opens to the tongue, and is associated with joy. When discussing the physiology and pathology of the heart, at least these aspects must be considered systematically to avoid a one-sided view. Therefore, each organ is a major system, and the five major systems are interconnected through meridians and Qi blood, forming a unity. These five major systems also coordinate, nourish, and suppress each other according to the laws of the five elements, engaging in various life activities under relatively stable conditions.(5) The Concept of Life in the Huangdi NeijingThe “Huangdi Neijing” denies the existence of a supernatural, immaterial deity, recognizing that life phenomena arise from the internal contradictions of the living being. It believes that the yin and yang Qi are the origin of all things. The “Su Wen: Yin Yang Ying Xiang Da Lun” states: “Yin and yang are the origin of all things.” Regarding the entire biological world, it states: “The Qi of heaven and earth interacts, and all things flourish and bear fruit; it also states: ‘The Qi of heaven and earth combines, and it is called human.'” The yin and yang Qi are in eternal motion, and their basic modes are ascent, descent, entry, and exit. The “Su Wen: Liu Wei Zhi Da Lun” states: “If entry and exit cease, the spirit’s mechanism will perish; if ascent and descent cease, Qi will stand alone and be in danger. Therefore, without entry and exit, there can be no growth, aging, or death; without ascent and descent, there can be no growth, transformation, or storage. Thus, life is characterized by ascent, descent, entry, and exit; there is no object that does not exist.” The “Huangdi Neijing” views essence as the fundamental substance that constitutes the living being and the original driving force of life. The “Ling Shu: Ben Shen” states: “The arrival of life is called essence; the union of two essences is called spirit.” In the “Ling Shu: Jing Mai”, it also describes the developmental process of embryonic life: “When a person is born, essence is first formed, and when essence is formed, the brain and marrow are born. Bones are the framework, vessels are the nourishment, tendons are the strength, flesh is the wall, skin is firm, and hair grows long.” This understanding of the material properties of life and embryonic development is fundamentally correct.(6) The Unity of Form and Spirit in the Huangdi NeijingThe “Huangdi Neijing” provides an explanation of the dialectical unity between the physical body and the spirit, indicating that the spirit is unified with the physical body, and the spirit arises from the life movement of the physical body. As the “Ling Shu: Xie Qi Zang Fu Bing Xing” states: “The twelve meridians and three hundred sixty-five collaterals, their Qi and blood all rise to the face and flow through the orifices; their essence and yang Qi rise to the eyes and become vision; their separate Qi flows to the ears and becomes hearing; their ancestral Qi rises from the nose and becomes smell; their turbid Qi flows from the stomach to the lips and tongue and becomes taste.” This indicates that vision, hearing, smell, and taste are physiological functions arising from the infusion of Qi, blood, and fluids into the various orifices. The higher neural centers governing cognitive activities are also explained from a materialistic perspective. The “Ling Shu: Ben Shen” states: “Thus, the arrival of life is called essence; the union of two essences is called spirit; the spirit that moves is called the soul; the essence that enters and exits is called the po. Therefore, the one who governs is called the heart; what the heart remembers is called intention; what intention holds is called will; through will, change occurs, which is called thought; through thought, distant longing occurs, which is called worry; through worry, dealing with objects occurs, which is called wisdom.”This description of human cognitive activities is fundamentally correct. Among the pre-Qin philosophers, no one has a clearer and more scientific understanding of the spirit and the relationship between form and spirit than the “Huangdi Neijing”. There are many discussions on the necessity of the unity of form and spirit, such as in the “Ling Shu: Tian Nian”: “When the spirit and Qi leave the heart, the soul and po are fully present, then one becomes human.” Also, in the “Su Wen: Shang Gu Tian Zhen Lun”: “Form and spirit must be together to complete their lifespan.” If form and spirit are not unified and do not correspond, a person will die. As the “Su Wen: Tang Ye Lao Li” states: “When the form is exhausted and the blood is depleted… the spirit cannot function.” Also, as the “Su Wen: Ni Diao Lun” states: “When the human body and will do not correspond, it is called death.” The viewpoint of the unity of form and spirit in the “Huangdi Neijing” has made a significant contribution to ancient Chinese philosophy.6. The Theoretical System of the Huangdi NeijingThroughout history, physicians have used classification methods to study the “Huangdi Neijing”. Among them, Yang Shangshan’s classification is the most detailed, dividing it into eighteen categories; Shen Youpeng’s is the simplest, dividing it into four volumes. The consensus among various scholars is that the four major theories are: organ representation (including meridians), pathogenesis, diagnostic methods, and treatment principles. These four major theories are the main content of the theoretical system of the “Huangdi Neijing”. They are described as follows:(1) Organ Representation TheoryThe organ representation theory studies the physiological functions of the body’s organs and meridian systems, their interconnections, and their external manifestations as well as their relationship with the external environment.The organ representation theory is based on the five organs, six bowels, and twelve meridians. The “Ling Shu: Jing Shui” states: “As for the eight-foot tall man, the skin and flesh are here, measurable and palpable externally. In death, it can be dissected and examined; the firmness and fragility of the organs, the size of the bowels, the quantity of food, the length of the pulse, the clarity or turbidity of the blood, the quantity of Qi, and the abundance or scarcity of the twelve meridians, whether they have more blood and less Qi, or more Qi and less blood, or both more blood and Qi, or both less blood and Qi, all have great significance.” Of course, the content related to anatomy is far more than this, but what is more important is that through extensive medical practice, this theory has gradually been enriched and ultimately reached a level that guides clinical practice.The “Huangdi Neijing” fully recognizes the dialectical principle of “what is within must manifest without”, making the organ representation theory systematic and complete. As the “Ling Shu: Ben Zang” states: “By observing the external, one can know the internal organs, thus knowing the disease.”The organ representation theory mainly includes three parts: organs, meridians, and essence, Qi, and spirit. The organs consist of the five organs, six bowels, and extraordinary organs. The five organs are the liver, heart, spleen, lung, and kidney. The “Su Wen: Wu Zang Bie Lun” states: “The so-called five organs are those that store essence and Qi without leaking, hence they are full but cannot be solid.” The “Ling Shu: Ben Zang” states: “The five organs are those that store essence, spirit, blood, Qi, soul, and po.” The six bowels are the gallbladder, stomach, large intestine, small intestine, bladder, and san jiao. The “Su Wen: Wu Zang Bie Lun” states: “The six bowels are those that transmit and transform substances without storing, hence they are solid but cannot be full.” The extraordinary organs are also classified as bowels but differ from the ordinary. They refer to the brain, marrow, bones, vessels, gallbladder, and female womb. Here, the gallbladder is one of the major bowels but also belongs to the extraordinary organs. The “Su Wen: Wu Zang Bie Lun” states: “The brain, marrow, bones, vessels, gallbladder, and female womb are the six that are born of earth Qi, all stored in yin and manifest on earth, hence they are stored but do not leak, called extraordinary organs.” Although the organs are differentiated by their shapes and functions, they are not isolated but cooperate and utilize each other. As the “Su Wen: Wu Zang Sheng Cheng Pian” states: “The heart is associated with the pulse, its color is its glory, and it governs the kidney; the lung is associated with the skin, its glory is its hair, and it governs the heart; the liver is associated with the tendons, its glory is its claws, and it governs the lung; the spleen is associated with the flesh, its glory is its lips, and it governs the liver; the kidney is associated with the bones, its glory is its hair, and it governs the spleen.” Similarly, the “Ling Shu: Ben Shu” states: “The lung is associated with the large intestine, the large intestine is the bowel of transmission; the heart is associated with the small intestine, the small intestine is the bowel of reception; the liver is associated with the gallbladder, the gallbladder is the bowel of central essence; the spleen is associated with the stomach, the stomach is the bowel of grains; the kidney is associated with the bladder, the bladder is the bowel of fluids. The san jiao is the bowel of the middle passage, from which the waterway emerges, and is the solitary bowel.”The meridian system can be divided into meridians, collaterals, and acupoints. The “Ling Shu: Ben Zang” states: “The meridians are those that circulate blood and Qi, nourish yin and yang, moisten tendons and bones, and benefit joints.” There are twelve primary meridians: Hand Taiyin Lung Meridian, Hand Yangming Large Intestine Meridian, Foot Yangming Stomach Meridian, Foot Taiyin Spleen Meridian, Hand Shaoyin Heart Meridian, Hand Taiyang Small Intestine Meridian, Foot Taiyang Bladder Meridian, Foot Shaoyin Kidney Meridian, Hand Jueyin Pericardium Meridian, Hand Shaoyang Sanjiao Meridian, Foot Shaoyang Gallbladder Meridian, Foot Jueyin Liver Meridian. The twelve meridians are interconnected like an endless loop, with Qi circulating within them in a continuous cycle. In addition to the primary meridians, there are also the eight extraordinary meridians: Du Mai, Ren Mai, Chong Mai, Dai Mai, Yin Qiao Mai, Yang Qiao Mai, Yin Wei Mai, and Yang Wei Mai. (It should be noted that the name “Eight Extraordinary Meridians” originated from the “Nan Jing: Twenty-Seven Difficulties”).The collaterals are those that connect and communicate between the meridians. The smaller ones are the numerous Sun Luo; the larger ones are fifteen, known as the fifteen collaterals. The “Ling Shu: Jing Mai” discusses this in detail, and here only the essentials are extracted: the branch of the Hand Taiyin is called Lie Que; the branch of the Hand Shaoyin is called Tong Li; the branch of the Hand Heart Master is called Nei Guan; the branch of the Hand Taiyang is called Zhi Zheng; the branch of the Hand Yangming is called Pian Li; the branch of the Hand Shaoyang is called Wai Guan; the branch of the Foot Taiyang is called Fei Yang; the branch of the Foot Shaoyang is called Guang Ming; the branch of the Foot Yangming is called Feng Long; the branch of the Foot Taiyin is called Gong Sun; the branch of the Foot Shaoyin is called Da Zhong; the branch of the Foot Jueyin is called Li Gou; the branch of the Ren Mai is called Wei Yi; the branch of the Du Mai is called Chang Qiang; the major collateral of the spleen is called Da Bao.The acupoints are where the meridian Qi enters and exits, functioning like transportation, hence they are named so. The “Huangdi Neijing” mentions acupoints first in the “Su Wen: Qi Xue Lun”, and again in the “Su Wen: Qi Fu Lun”, both mentioning three hundred sixty-five acupoints. In reality, the “Qi Xue Lun” lists three hundred forty-two acupoints, while the “Qi Fu Lun” lists three hundred eighty-six acupoints.The essence, Qi, and spirit are the three treasures of the human body. Essence includes essence, blood, fluids; Qi refers to the ancestral Qi, nourishing Qi, and defensive Qi; spirit refers to the spirit, soul, po, intention, and will. The “Ling Shu: Ben Zang” states: “The blood, Qi, and spirit of a person are what sustain the body and circulate through life.” Essence and Qi are the fundamental substances that constitute the human body, while Qi and spirit are the complex functions of the human body. It can also be said that Qi is the master of essence, essence is the residence of spirit, and spirit is the function of essence and Qi.(2) Pathogenesis TheoryThe theory that studies the internal mechanisms of disease occurrence, development, transformation, and changes is called pathogenesis theory.The “Huangdi Neijing” states: “Examine the pathogenesis carefully, and do not lose the appropriate Qi” and “Guard the pathogenesis carefully, each has its own role” (both from the “Su Wen: Zhi Zhen Yao Da Lun”). This is the content of this theory, which can be described from three aspects: etiology, onset, and disease change:1. Etiology: There are many causes of disease onset, and the “Huangdi Neijing” categorizes them into two types. The “Su Wen: Diao Jing Lun” states: “The emergence of evil can arise from yin or from yang. Those arising from yang are due to wind, rain, cold, and heat; those arising from yin are due to diet, living conditions, and the emotions of joy, anger, and sadness.” Wind, rain, cold, and heat are a summary of the “six evils”; the emotions of joy, anger, and sadness are a summary of the “seven emotions”; diet and living conditions refer to “dietary labor and fatigue”. This can be considered the origin of the later three causes theory.2. Onset: The comparison of the strengths of the righteous and the evil determines the occurrence and development of disease. The “Ling Shu: Bai Bing Shi Sheng” states: “Wind, rain, cold, and heat cannot harm a person without the presence of deficiency. If one suddenly encounters a strong wind or heavy rain and does not fall ill, it is because there is no deficiency. Therefore, evil cannot harm a person alone; this must be due to the deficiency of the wind and the body, where both deficiencies interact, thus overcoming the body.” This conveys the idea that “when the righteous Qi is present, the evil cannot invade”. The “Su Wen: Shang Gu Tian Zhen Lun” states: “When the spirit is internally guarded, where does the disease come from?” The “Su Wen: Ping Re Bing Lun” states: “Where the evil gathers, its Qi must be deficient,” all of which support this point.3. Disease Change: The changes in disease are complex, and the “Huangdi Neijing” summarizes the changes in disease in various aspects, including those summarized by yin and yang, such as in the “Su Wen: Yin Yang Ying Xiang Da Lun”: “Yang receives wind Qi, and yin receives damp Qi”; “Yang diseases ascend to the extreme and descend, while yin diseases descend to the extreme and ascend”; “When yin prevails, yang diseases occur; when yang prevails, yin diseases occur. When yang prevails, it is heat; when yin prevails, it is cold”; “When yang is affected, it enters the six bowels; when yin is affected, it enters the five bowels.” The “Su Wen: Xuan Ming Wu Qi Pian” also states: “Evil entering yang leads to mania, evil entering yin leads to numbness; affecting yang leads to epilepsy, affecting yin leads to paralysis; when yang enters yin, it leads to tranquility, when yin exits yang, it leads to anger.”Using the internal and external to summarize, as in the “Su Wen: Yu Ji Zhen Zang Lun”: “When the Qi comes strong and solid, this is called excess, and the disease is external; when the Qi comes weak and feeble, this is called deficiency, and the disease is internal.” Also, as in the “Su Wen: Zhi Zhen Yao Da Lun”, there are patterns of disease change such as “from internal to external”, “from external to internal”, “from internal to external and strong externally”, “from external to internal and strong internally”, and “internal and external do not affect each other”.Using cold and heat to summarize, as in the “Ling Shu: Ci Jie Zhen Xie”: “When yang is strong, it leads to heat; when yin is strong, it leads to cold.” Also, as in the “Su Wen: Diao Jing Lun”: “When yang is deficient, it leads to external cold; when yin is deficient, it leads to internal heat; when yang is strong, it leads to external heat; when yin is strong, it leads to internal cold.”From the perspective of deficiency and excess, as in the “Su Wen: Tong Ping Xu Shi Lun”: “When the evil Qi is strong, it is excess; when the essence Qi is depleted, it is deficiency.” Also, as in the “Su Wen: Diao Jing Lun”: “Where Qi gathers, it leads to blood deficiency; where blood gathers, it leads to Qi deficiency.” Excess refers to the strong evil Qi, while deficiency refers to the weak righteous Qi. In summary, there are cases of righteous deficiency and evil excess, cases of evil excess and righteous deficiency, cases of righteous deficiency without evil excess, and cases of righteous presence without evil presence.The above is a summary of the pathogenesis theory.(3) Diagnostic Method TheoryThe four diagnostic methods of observation, listening, inquiry, and palpation originated from the “Huangdi Neijing”, as the “Su Wen: Yin Yang Ying Xiang Da Lun” states: “A good diagnostician observes color and palpates the pulse, first distinguishing between yin and yang, examining clarity and turbidity, and knowing the parts; observes breathing, listens to sounds, and knows the suffering; observes weight and measures, and knows the main disease; palpates the dimensions, observes floating, sinking, slippery, and rough, and knows the origin of the disease. By treating without excess, and diagnosing without loss, one can achieve success.” Also, the “Ling Shu: Xie Qi Zang Fu Bing Xing” states: “By seeing the color, one knows the disease, this is called brightness; by palpating the pulse, one knows the disease, this is called spirit; by inquiring about the disease, one knows the location, this is called skill.” The “Huangdi Neijing” discusses diagnostic methods extensively, and the following is a list according to the order of observation, listening, inquiry, and palpation:1. Observation: This includes observing the spirit color, examining the shape, and discerning the tongue coating.Observing the spirit color, as in the “Ling Shu: Wu Se”: “The five colors each appear in their respective parts, observing their floating and sinking to know the depth; observing their luster to see success or failure; observing their dispersion to know distance; observing the color above and below to know the location of the disease; accumulating spirit in the heart to know the past and present.” Also, as in the “Ling Shu: Wu Yue Wu Shi”: “For lung disease, there is wheezing and nasal swelling; for liver disease, there is a greenish hue; for spleen disease, there are yellow lips; for heart disease, there is a rolled and short tongue, and red cheeks; for kidney disease, there are dark cheeks and complexion.” Also, the “Ling Shu: Wu Se” states: “If red appears on both cheeks, as large as a mother’s thumb, although the disease is small, it will surely lead to death.” These observations are very significant in clinical practice.Examining the shape, as in the “Su Wen: Jing Mai Bie Lun”: “The way to diagnose disease is to observe a person’s courage or fear, bones and flesh, skin, and be able to know their condition, which serves as a diagnostic method.” This is an example of inferring the condition by examining the bones, flesh, and skin of a person. Also, as in the “Su Wen: Ci Zhi Lun” states: “When Qi is solid, the form is solid; when Qi is weak, the form is weak; this is the norm; if reversed, it indicates disease.”In clinical practice, deficiency and excess are complex; only by knowing the norm can one understand the changes.Discerning the tongue coating, as in the “Su Wen: Re Lun”: “In the fifth day of a cold, the mouth is dry, the tongue is dry, and there is thirst.” The “Su Wen: Ci Re Lun”: “For lung heat disease, the tongue has a yellow coating.” Also, the “Ling Shu”: “If the root of the tongue is rotten and heat does not cease, it is death.” Other conditions such as “bleeding from the root of the tongue”, “dry root of the tongue”, “strong root of the tongue”, “rolled tongue”, “withered tongue”, etc., cannot all be listed.2. Listening: This includes listening to sounds and smelling odors.Listening to sounds, as in the “Su Wen: Yin Yang Ying Xiang Da Lun”: “Listen to sounds and know the suffering; for spleen, it is in motion and leads to hiccups”; also, as in the “Su Wen: Ci Re Lun”: “For liver heat disease, the heat causes madness and agitation.” Again, as in the “Su Wen: Diao Jing Lun”: “When the spirit is abundant, one laughs incessantly; when the spirit is insufficient, one grieves.” These are all examples of diagnosing disease by listening to the patient’s voice.Next is smelling odors, as the “Su Wen: Jin Kui Zhen Yan Lun” states: “For liver disease, the odor is foul; for heart disease, the odor is burnt; for spleen disease, the odor is fragrant; for lung disease, the odor is fishy; for kidney disease, the odor is rotten.”3. Inquiry: Inquiring about the patient’s subjective symptoms to diagnose the disease is called inquiry. As the “Su Wen: San Bu Jiu Hou Lun” states: “One must carefully inquire about the onset of the disease and the current condition”; also, as the “Su Wen: Yi Jing Bian Qi Lun” states: “Close the doors and windows, and for those who are ill, ask them repeatedly about their condition to understand their intentions.” Also, as the “Su Wen: Shu Wu Guo Lun”: “For anyone wishing to diagnose a disease, one must inquire about diet, living conditions, sudden joys and sorrows, and the initial joy followed by sorrow.”4. Palpation: This includes pulse palpation and skin palpation. The “Huangdi Neijing” discusses pulse palpation in great detail, making it difficult to summarize comprehensively, so only the essentials are selected:(1) The three divisions and nine pulses method: This divides the head, hands, and feet into three divisions, each with three pulses. See the “Su Wen: San Bu Jiu Hou Lun” for details.(2) The Ren Mai and Cun Kou pulse method: This involves diagnosing the Ren Mai and Cun Kou pulses, comparing them with each other. See the “Ling Shu: Zhong Shi”, “Si Shi Qi”, “Jin Fu”, “Wu Se” for details.(3) The breath adjustment method: This involves adjusting the physician’s breathing to diagnose the patient’s pulse condition. As the “Su Wen: Ping Ren Qi Xiang Lun” states: “Always adjust the patient who is not ill to treat the ill; the physician does not fall ill, hence the patient is calmed to adjust them as a method. When a person exhales, the pulse moves once; when a person inhales, the pulse moves once, this is called slight Qi. When a person exhales, the pulse moves three times; when a person inhales, the pulse moves three times, and if it is rapid and hot, it is called illness; if the pulse is not hot and the pulse is slippery, it is called wind; if the pulse is rough, it is called numbness. If a person exhales more than four times, it is called death; if the pulse is absent, it is called death; if it fluctuates and is erratic, it is called death.”(4) The stomach Qi pulse: The presence or absence of stomach Qi in the pulse is crucial; if there is stomach Qi, there is life; if there is no stomach Qi, there is death. As the “Su Wen: Ping Ren Qi Xiang Lun” states: “In spring, if the stomach pulse is slightly arched, it is normal; if it is overly arched and the stomach is less, it indicates liver disease; if it is completely arched and there is no stomach Qi, it indicates death.” “In summer, if the stomach pulse is slightly hooked, it is normal; if it is overly hooked and the stomach is less, it indicates heart disease; if it is completely hooked and there is no stomach Qi, it indicates death.” “In late summer, if the stomach pulse is slightly weak, it is normal; if it is overly weak and the stomach is less, it indicates spleen disease; if it is completely absent of stomach Qi, it indicates death.” “In autumn, if the stomach pulse is slightly fine, it is normal; if it is overly fine and the stomach is less, it indicates lung disease; if it is completely absent of stomach Qi, it indicates death.” “In winter, if the stomach pulse is slightly solid, it is normal; if it is overly solid and the stomach is less, it indicates kidney disease; if it is completely absent of stomach Qi, it indicates death.”(5) The six pulse categories: The “Huangdi Neijing” records many pulse types, such as floating, sinking, slow, rapid, weak, strong, slippery, rough, long, short, taut, fine, subtle, moist, soft, weak, scattered, slow, firm, moving, surging, hidden, knotted, intermittent, large, small, urgent, solid, prosperous, rapid, hooked, fine, stone, nourishing, and panting, etc. However, it is often summarized using the six pulses, as the “Ling Shu: Xie Qi Zang Fu Bing Xing” states: “Adjust the pulse’s slow, rapid, large, small, slippery, and rough, and the disease change will be determined.”Next is skin palpation: The skin refers to the entire body’s skin, and there are many contents that assist in diagnosis through skin palpation, such as “palpating and following it”, “palpating and bouncing it”, etc. However, the most detailed discussion is on the palpation of the wrist. As the “Ling Shu: Lun Ji Zhen” states: “I wish to diagnose without observing color and only by palpating the wrist, how can I determine the disease?” The response is: “Examine the wrist’s slow, rapid, large, small, slippery, and rough, and the condition of the flesh will determine the disease.” Because the pulse and wrist skin have a necessary connection, thus during diagnosis, they can also complement each other. Therefore, the “Ling Shu: Xie Qi Zang Fu Bing Xing” states: “If the pulse is rapid, the wrist skin is also rapid; if the pulse is slow, the wrist skin is also slow; if the pulse is small, the wrist skin is also reduced and has little Qi; if the pulse is large, the wrist skin is also raised; if the pulse is slippery, the wrist skin is also slippery; if the pulse is rough, the wrist skin is also rough. All these changes vary in degree.”(4) Treatment Principle TheoryThe theory that studies treatment principles is called treatment principle theory. The “Huangdi Neijing” has extensive research on treatment principles, which can be summarized from the following aspects:1. Preventing Minor Issues from Becoming Major Ones: This includes preventing disease before it occurs and preventing changes once disease has occurred. As the “Su Wen: Shang Gu Tian Zhen Lun” states: “Avoid the virtual evil and the wind at the right time; maintain tranquility and emptiness, and the true Qi will follow; guard the spirit internally, and disease will not arise from there,” and “Diet should be moderate, daily routines should be regular, and one should not overwork, thus the form and spirit can be together, and one can live to a hundred years and then depart.” The principles of “nurturing yang in spring and summer, and nurturing yin in autumn and winter” all emphasize the prevention of disease. For those who are ill, early treatment to prevent transmission and change, as the “Su Wen: Yin Yang Ying Xiang Da Lun” states: “Therefore, when the evil wind arrives, it is as swift as wind and rain; thus, a good physician treats the skin first, then the muscles, then the tendons, then the six bowels, and finally the five organs. Treating the five organs is half dead and half alive.”2. Adapting to Time, Place, and Person: Adapting to time means, as the “Su Wen: Liu Yuan Zheng Ji Da Lun” states: “When the Qi is hot, use heat without transgressing; when the Qi is cold, use cold without transgressing; when the Qi is cool, use cool without transgressing; when the Qi is warm, use warm without transgressing.” This advises physicians not to violate the four seasonal temperatures when prescribing medicine.Adapting to place means, as stated in the same chapter: “In high places, winter Qi is always present; in low places, spring Qi is always present”; thus, treatment should not be one-size-fits-all, but must be distinguished. The “Su Wen: Yi Fa Fang Yi Lun” discusses in detail the differences in treatment for the east, south, west, and north, stating that “for diseases in the east, it is suitable to use stone needles; in the west, it is suitable to use toxic medicines; in the north, it is suitable to use moxibustion; in the south, it is suitable to use fine needles; in the center, it is suitable to use guiding and pressing.”Adapting to person means, as the “Su Wen: Wu Chang Zheng Da Lun” states: “Those who can endure toxins should use strong medicines; those who cannot endure toxins should use mild medicines.” Also, as the “Su Wen: Zheng Si Shi Lun” states: “Not adapting to the rich or poor, the thick or thin of the sitting place, the cold or warm of the body, not adapting to dietary suitability, not adapting to the courage or fear of others, not knowing comparisons, leads to confusion, and not knowing the distinctions leads to clarity; this is the three losses of treatment.”3. Prioritizing Symptoms and Root Causes: This refers to treating the main and secondary aspects of the disease in order. The “Su Wen: Zhi Zhen Yao Da Lun” states: “The way of symptoms and root causes is to be broad and small, to be able to speak of one and know the harm of a hundred diseases. Speaking of symptoms and root causes is easy and should not be damaged; examining symptoms and root causes, Qi can be adjusted.” The principles of prioritizing symptoms and root causes are most thoroughly discussed in the “Su Wen: Biao Ben Bing Chuan Lun”, which will not be elaborated here.4. Seeking the Root of the Disease: This is the most fundamental principle in the treatment principles of the “Huangdi Neijing”. The “Su Wen: Yin Yang Ying Xiang Da Lun” states: “When treating diseases, one must seek the root.”5. Guiding by the Situation: Based on seeking the root of the disease, one should cleverly adapt. For example, “if it is light, then promote it; if it is heavy, then reduce it; if it is weak, then strengthen it; if it is strong, then drain it”; “if it is on the skin, then sweat it out”. (All from the “Su Wen: Yin Yang Ying Xiang Da Lun”).6. Coordinating Yin and Yang: This is a major principle of treatment, hence the “Su Wen: Zhi Zhen Yao Da Lun” states: “Carefully observe where yin and yang are located and adjust them, aiming for balance.” The “Su Wen: Yin Yang Ying Xiang Da Lun” states: “Yang diseases are treated with yin, and yin diseases are treated with yang.”7. Direct and Indirect Treatment: Direct treatment, also known as reverse treatment, refers to treatment methods that are contrary to the disease condition. For example, “heat is treated with cold, cold is treated with heat, deficiency is supplemented, and excess is drained”; indirect treatment, also known as following treatment, refers to methods such as “cold is treated with cold, heat is treated with heat, unblocking is treated with unblocking, and blocking is treated with blocking”. Thus, the “Su Wen: Zhi Zhen Yao Da Lun” states: “For mild cases, treat them directly; for severe cases, treat them indirectly. Direct treatment is for reverse treatment, and indirect treatment is for following treatment, adjusting according to the situation.”8. Moderation in Treatment: Whether supporting the righteous or expelling the evil, it should be done in moderation, especially for mixed conditions of deficiency and excess. It is crucial to remember “no excess in excess, no deficiency in deficiency”, meaning that even when supplementing, one should not overdo it. Because “long-term increase in Qi is the norm, and prolonged increase in Qi leads to premature death” (“Su Wen: Zhi Zhen Yao Da Lun”). The “Su Wen: Wu Chang Zheng Da Lun” also states: “For major toxins treating diseases, ten should be reduced by six; for common toxins treating diseases, ten should be reduced by seven; for minor toxins treating diseases, ten should be reduced by eight; for non-toxic treatments, ten should be reduced by nine. Grains, meat, fruits, and vegetables should be consumed in moderation, without excess, to avoid harming the righteous Qi.”9. Disease is the Root, Treatment is the Branch: The “Su Wen: Tang Ye Lao Li Lun” states: “Disease is the root, treatment is the branch.” This means that the disease is an objective existence, which is the root; the physician’s understanding and treatment of the disease is the branch. Physicians must base their treatment on the disease, so that the root and branch can correspond, leading to the cure of the disease.10. Diagnosis and Treatment Based on Differentiation: Although the “Huangdi Neijing” does not explicitly propose the term “differentiation and treatment”, it embodies the practice of differentiation and treatment. The above points all imply this, and the text already contains the connotations of organ differentiation, meridian differentiation, eight principles differentiation, and six meridian differentiation.11. Formulating Prescriptions and Dispensing Medicines: Although the “Huangdi Neijing” does not contain many prescriptions, the principles of its prescriptions are already present. The “Su Wen: Zhi Zhen Yao Da Lun” states: “Spicy and sweet disperse for yang, sour and bitter drain for yin, salty flavors drain for yin, bland flavors drain for yang. The six can either gather or disperse, either slow or fast, either dry or moist, either soft or hard, depending on what is beneficial, adjusting the Qi to achieve balance.” Also, “the main disease is called the monarch, the assisting is called the minister, and the responding is called the envoy”; “one monarch and two ministers is a small prescription; one monarch and three ministers is a medium prescription; one monarch and three ministers with nine is a large prescription; one monarch and two ministers is an odd prescription; one monarch and two ministers with four is an even prescription; one monarch and two ministers with three is an odd prescription; one monarch and two ministers with six is an even prescription. Therefore, it is said: the near is odd, the far is even; those who sweat should not use odd, those who are down should not use even; supplementing above treats above, while supplementing below treats below; if urgent, the flavors are thick; if slow, the flavors are thin; this is what is meant.”12. Acupuncture and Moxibustion: The “Huangdi Neijing” discusses meridians, acupoints, acupuncture, and moxibustion extensively, making it difficult to list all. Just regarding the methods of supplementation and draining, there are methods of breathing supplementation and draining (see “Su Wen: Li He Zhen Xie Lun”), formula supplementation and draining (see “Su Wen: Ba Zheng Shen Ming Lun” and “Ling Shu: Guan Neng”), deep and shallow supplementation and draining (see “Ling Shu: Zhong Shi”), slow and rapid supplementation and draining (see “Su Wen: Zhen Jie Pian”), and light and heavy supplementation and draining (see “Ling Shu: Jiu Zhen Shi Yuan”), etc. These methods have been continuously used by later generations.
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