金匱真言論篇第四 Su Wen Chapter 4
Updated: Jul 27, 2020
Note: This chapter discusses the four seasons and five elements as the central theme, i.e. how they relate to the human body, the pathogenesis and etiology of disease as it relates to the natural environment. There are many basic medical principles emphasized in this chapter by the author, and that is why they are placed in the "golden cabinet" 金匱 to signify their significance, and hence the name for this chapter as "Golden Cabinet Discussions on the Theory of Truth".
黃帝 asks: "There are 8 winds in the sky, but the channels have 5 winds, why is that?"
岐伯 answered: "The 8 winds in the natural world are what causes disease, and they in turn cause the winds in the channels, affecting the 5 yin organs; the onset of disease from evil qi, is from acquiring the constrains of the four seasons; the spring constrains the long summer (the period between summer and autumn), the long summer constrains the winter, the winter constrains the summer, the summer constrains the autumn, the autumn constrains the spring, this is what is known as the constrains of the four seasons (四時之勝).
Note: the four seasons matched with the 5 elements(yin organs) are thus: spring=wood(Liver)春木肝, summer=fire(Heart)夏火心, long summer=earth(Spleen)長夏土脾, autumn=metal(Lung)秋金肺, and winter=water(Kidneys)冬水腎. The Chinese medicine theory of organs are "organ functional systems" as they describe a set of functions in addition to the anatomical organ in Western medicine so they are capitalized to differentiate from the anatomical organ. The spring qi affects the Liver and allows it to flourish; the summer, the Heart etc... When the text refers to the spring "constrains"(overpower) the long summer, it means the spring qi showing up in the long summer and causing disease. So this is a Liver wood getting help from the errant spring qi in the long summer to overact on Spleen earth and cause disease of Liver excess and Spleen damage. This is also relates to the control cycle in 5 element theory.
Easterly wind arises in the spring, corresponding illness resides in the Liver, the access transport is at the neck/nape.
Southerly wind arises in the summer, corresponding illness resides in the Heart, the access transport is at the middle of the chest.
Westerly wind arises in the autumn, corresponding illness resides in the Lung, the access transport is at the shoulder and upper back.
Northerly wind arises in the winter, corresponding illness resides in the Kidneys, the access transport is the waist to the legs.
Center is the earth, corresponding illness resides in the Spleen, and the access transport is the spine.
If disease due to spring qi, illness manifests at the head;
if due to the summer qi, illness manifests at the organs;
if due to the autumn qi, illness manifests at the shoulders and back;
if due to the winter qi, illness manifests in the four limbs.
It is said that it is common to see epistaxis in the spring, the summer common to see chest attack, the long summer common to see diarrhea and cold accumulation in the middle, the autumn common to see wind malaria, and the winter common to see bi reversal syndrome (the four limbs are cold and numb from reversal of flow)
It is said that if in the winter don't over exercise to strain the sinews and muscles and leak yang qi, then won't see the epistaxis in the spring, no chest attack in the summer, no diarrhea nor cold accumulation in the middle in the long summer, no wind malaria in the autumn, no bi reversal syndrome, diarrhea and cold sweat in the winter.
It is said that the essence is the basis of the body. It is said that if store the essence well in the winter, then the spring won't be attacked by warm disease; if the summer heat isn't sweat out properly, it could transform to wind malaria in the autumn. This is the method to restore to even pulse.
It is mentioned since the ages: "There is yin within yin, and yang within yang.
From 6:00(平旦|卯时)-12:00(日中|午时) the yang of the sky, and is the yang within yang.
From 12:00-18:00(黃昏｜酉时) the yang of the sky, and is the yin within yang.
From 18:00(合夜)-24:00(雞鳴｜子时), the yin of the sky, and is the yin within yin.
From 24:00-6:00, it is the yin of the sky, they yang within the yin.
So it is the same pattern for humans.
Regarding the yin and yang of the human, the exterior is yang and the interior is yin.
Regarding the yin and yang of the human body, the back is the yang, the abdomen is the yin.
Regarding the yin and yang of the yin organs(zang) and yang organs(fu), the zang is yin, and fu is yang; Liver, Heart, Spleen, Lung, Kidney 5 zang are yin, the Gall Bladder, Stomach, Large Intestine, Small Intestine, Urinary Bladder and San Jiao 6 fu are yang.
So why should we care about is yin within yin and yang within yang?
The winter disease is in yin, summer disease in yang, spring disease in yin, autumn disease in yang, one needs to know where the disease lies in yin and yang to determine how to needle(針) and use stone needle(砭石)therapy.
It is said the back(upper chest) is yang, the yang within yang corresponds to the Heart; the yin of the yang corresponds the Lung.
It is said the abdomen(below diaphragm) is yin, the yin within yin corresponds to the Kidneys, the yang within yin corresponds to the Liver; the ultimate yin within yin corresponds to the Spleen. This is the yin and yang reflected in the surface and core, inside and outside, masculine and feminine and is a reflection of the yin and yang of the universe."
黃帝 mentions: "The 5 zang responds to/reflects the 4 seasons, each with its own way?"
岐伯 answers: "Yes.
The easterly green color enters the Liver, orifices the eyes, stores its essence in the Liver, illness onset are often quite frightening, its corresponding flavor is sour; element is plants; animal is the chicken; grain is wheat(麦); of the 4 seasons, star is Jupiter(歲星|木星); the spring qi will manifest at the head; sound is Mi(角3/E) ; number is 8; the diseases manifest in the sinews; smell is animal urine like.
The southerly red color enters the Heart, orifices the ear, stores its essence in the Heart, illness will be in the 5 zang; the favor is bitter; element is fire; animal is goat; grain is millet(黍|黃米); of the 4 seasons, star is Mars(荧惑星|火星); the disease manifests in the vessels; the sound is Sol (徵5/G); number is 7; the smell is burnt.
The center yellow color enters to the Spleen, orifice the mouth, stores its essence in the Spleen, illness will be in the root of the tongue; flavor is sweet, element is earth; animal is cow; grain is millet(稷|小米); of the four seasons, star is Saturn(鎮星|土星); the disease manifests in the muscles; the sound is Do(宫1/C); the number is 5; the smell is fragrant.
The westerly white color enters to the Lung, orifices the nose; stores its essence in the Lung; illness will be in the back/upper chest; the taste is spicy; element is metal; animal is horse; grain is rice(稻); of the four seasons, star is Venus(太白星|金星); disease manifests in the skin and body hair; the sound is Re(商2/D); the number 9; the smell is pungent.
The northerly black color enters to the Kidney; orifices the anus and urethra(二陰); stores its essence in the Kidneys; the illness will be at the small meeting points of the muscles(谿); the flavor is salty; the element is water; the animal is pig; grain is bean(豆); of the four seasons, the star is Mercury(辰星|水星)；disease manifests in the bone; the sound is La(羽6/A); the number 6; the smell rotten.
It is said that someone who is good at pulse diagnosis is someone who carefully inspects the 5 zang and 6 fu, at once counteracting and another following, yin and yang, exterior and interior, masculine and feminine principles all committed into the heart and mind, refining the skills to its essence with the heart's intention. Do not teach to those who do not possess the similar discipline and ethics with purpose to serve all; do not confer the knowledge to those who are not authentic and genuine, this is what it means to understand and practice the Dao. (I think this last sentence is about being mindful about sharing the refined essence of yourself and your work. when it comes to good medicine, carefully passing on the knowledge to those that are authentic in following the way will allow it to pass on in most beneficially to all, or else it will not be of the Dao. Also treat your work and knowledge as a port of your essence, refine it, keep it secure and not leaking without discipline as you follow the way to nourish life.)