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Huangdi Neijing · The Yellow Emperor’s Inner Canon
Suwen 19 · The Jade Mechanism and True Organ Pulses
Read in English. Switch to Original for word notes, or select text to ask a question.
The Yellow Emperor asked: “The spring pulse is like a string. How is it stringlike?”
Qi Bo replied: “The spring pulse belongs to Liver, eastern Wood, through which all things begin to grow. Its qi arrives soft, weak, light, empty and slippery, straight and long: therefore stringlike. Contrary to this is illness.”
The Emperor asked: “How is it contrary?”
Qi Bo said: “Replete, strong arrival is excess, with illness outside. Arrival lacking repletion and faint is insufficiency, with illness within.”
The Emperor asked: “What illnesses follow spring excess and insufficiency?”
Qi Bo said: “Excess brings forgetfulness, confused dizziness and illness at the crown. Insufficiency brings chest pain drawing into the back and fullness below in both flanks.”
The Emperor said: “Good. The summer pulse is like a hook. How is it hooklike?”
Qi Bo said: “The summer pulse belongs to Heart, southern Fire, through which all things grow abundantly. Its qi arrives strongly and departs weakly: therefore hooklike. Contrary to this is illness.”
The Emperor asked: “How is it contrary?”
Qi Bo said: “Strong arrival and equally strong departure is excess, with illness outside. Arrival not strong but departure strong is insufficiency, with illness within.”
The Emperor asked: “What illnesses follow summer excess and insufficiency?”
Qi Bo said: “Excess brings bodily heat and painful skin with spreading lesions. Insufficiency brings agitation at Heart, cough and spitting above, and discharge of qi below.”
The Emperor said: “Good. The autumn pulse floats. How does it float?”
Qi Bo said: “The autumn pulse belongs to Lung, western Metal, through which all things gather and mature. Its qi arrives light, empty and floating, arriving urgently and departing scattered: therefore floating. Contrary to this is illness.”
The Emperor asked: “How is it contrary?”
Qi Bo said: “Hairlike arrival with a firm center and empty sides is excess, with illness outside. Hairlike and faint arrival is insufficiency, with illness within.”
The Emperor asked: “What illnesses follow autumn excess and insufficiency?”
Qi Bo said: “Excess brings counterflow qi, back pain and oppressed discomfort. Insufficiency brings panting, scant qi in breathing and cough, upward qi with visible blood, and diseased sounds heard below.”
The Emperor said: “Good. The winter pulse is called ying. What makes it ying?”
Qi Bo said: “The winter pulse belongs to Kidney, northern Water, through which all things close and store together. Its qi arrives sinking and beating: therefore called ying. Contrary to this is illness.
Reading note: Ying, 營, is retained as the supplied winter-pulse name; it is not silently replaced with stone.”
The Emperor asked: “How is it contrary?”
Qi Bo said: “Arrival like flicking a stone is excess, with illness outside. Its departure as though rapid is insufficiency, with illness within.”
The Emperor asked: “What illnesses follow winter excess and insufficiency?”
Qi Bo said: “Excess brings lassitude, pain in the vessels along the spine, scant qi and reluctance to speak. Insufficiency brings a suspended feeling at Heart like hunger, cold within the flank region, pain within the spine, fullness in the lower abdomen and altered urination.
Reading note: The supplied 解聡 follows the same lassitude reading as before. The obscure 眇中 is rendered broadly as the flank region without adding a precise modern organ.”
The Emperor said: “Good.”
The Emperor asked: “The seasonal sequence has its contrary and following variations. What does the Spleen pulse alone govern?”
Qi Bo said: “The Spleen pulse is Earth, the solitary organ that irrigates the four sides.”
The Emperor asked: “Can its favorable and unfavorable states be seen?”
Qi Bo said: “The favorable cannot be seen; the unfavorable can.”
The Emperor asked: “How can the unfavorable be seen?”
Qi Bo said: “Arrival like flowing water is excess, with illness outside. Arrival like a bird’s beak is insufficiency, with illness within.”
The Emperor asked: “You say Spleen is the solitary organ, central Earth irrigating the four sides. What illnesses follow its excess and insufficiency?”
Qi Bo said: “Excess prevents lifting the four limbs. Insufficiency blocks the nine openings. This is called doubled rigidity.”
The Emperor rose in awe, bowed twice and touched his head to the ground: “Excellent. I have obtained the great essentials of the pulse and the realm’s ultimate reckoning: changes of five colors and pulses, measurement and extraordinary patterns, whose Way is one. Spirit turns without reversing; reversed, it no longer turns and loses its mechanism. The essential of ultimate reckoning approaches the subtle. Inscribe it on a jade tablet, store it in the treasury and read it every dawn. It shall be called the Jade Mechanism.”
The five zang organs receive qi from what they generate, transmit it to what they overcome, lodge qi in what generates them, and die through what overcomes them. Before fatal illness ends, transmission must reach what they cannot overcome. This is qi traveling contrary, and therefore death.
Liver receives qi from Heart, transmits to Spleen, lodges qi in Kidney and dies upon reaching Lung. Heart receives from Spleen, transmits to Lung, lodges in Liver and dies upon reaching Kidney. Spleen receives from Lung, transmits to Kidney, lodges in Heart and dies upon reaching Liver. Lung receives from Kidney, transmits to Liver, lodges in Spleen and dies upon reaching Heart. Kidney receives from Liver, transmits to Heart, lodges in Lung and dies upon reaching Spleen.
All are contrary courses ending in death. Divide day and night into five parts to judge whether the time of life or death is early or late.
Reading note: The opening repeats 所生 for receiving and lodging, while its explicit examples distinguish child and parent. The examples and both relationships are retained.
The Yellow Emperor said: “The five zang organs communicate, and transfer proceeds in sequence. Each ill organ transmits to what it overcomes. Untreated, the rule is three or six months, or three or six days, for transmission through the five organs and death. This follows the sequence of what each overcomes. Thus distinguishing yang reveals where illness came from; distinguishing yin reveals the period of life or death—knowing when it reaches the organ that confines it and death follows.
Wind leads a hundred illnesses. Wind and cold lodging in a person make every fine hair stand, close the skin and produce heat. At this stage sweating can release them. Or painful obstruction, numbness, swelling and pain occur; warm liquid compresses, fire, moxa or needling can remove them.
Untreated, illness enters Lung: Lung obstruction, with cough and upward qi. Untreated, Lung transmits to Liver: Liver obstruction, also called counterflow, with flank pain and bringing up food. Pressing or needling can then be used. Untreated, Liver transmits to Spleen: Spleen Wind, with heat disorder, abdominal heat, agitation at Heart and yellow color. Pressing, medicines or bathing can then be used.
Untreated, Spleen transmits to Kidney: hernia and masses, with oppressive heat and pain in the lower abdomen and white discharge, also called gu. Pressing or medicines can then be used. Untreated, Kidney transmits to Heart: sinews and vessels draw tightly together, called convulsion. Moxa or medicines can then be used. Untreated, ten full days ordinarily bring death. If Kidney transmits to Heart and Heart returns transmission to Lung, cold and heat arise; the rule is death in three years. This is the illness’s sequence.
Sudden onset need not wait for the transmission sequence, and some transformations enter out of order. Worry, fear, grief, joy and anger disrupt the sequence, producing grave illness. Great deficiency through joy lets Kidney qi override; anger lets Liver qi override; grief Lung qi; fear Spleen qi; worry Heart qi. This is their course. Thus five illnesses have five times five, twenty-five variations, together with their transmissions and transformations. Transmission names this overriding.
Great bones withered, great flesh sunken, qi filling the chest and breathing difficult enough to move the bodily form predicts death in six months. When the true organ pulse appears, its day can be assigned.
The same with internal pain drawing into shoulder and nape predicts death in one month; appearance of the true organ pulse assigns its day. The same with shoulder and nape pain, bodily heat, lost flesh and broken muscle masses, and a true organ pulse, means death within ten months.
Great bones withered, great flesh sunken, marrow within the shoulders wasting and movement increasingly weak, with a true organ pulse, predicts death within one zang period. The particular true organ pulse assigns the day.
Great bones withered, great flesh sunken, chest full of qi, abdominal pain, discomfort at Heart, heat in shoulder, nape and body, broken muscle masses, lost flesh and sunken eye sockets, with a true organ pulse: inability to see people means immediate death. If people can still be seen, death occurs when the overcoming influence reaches its time.
Sudden urgent deficiency within the body closes and cuts off the five organs. Vessel pathways no longer communicate and qi does not come and go, as in falling or drowning: no appointed period can be given. If the pulse ceases, or arrives five or six times within one breath, death still follows even without wasted flesh or a visible true organ pulse.
The true Liver pulse is urgent inside and out, harsh as tracing a knife edge or pressing zither strings. Blue-green and white color without luster, with broken body hair, means death. The true Heart pulse is firm and beating like successive coix seeds. Red and black without luster, with broken hair, means death. The true Lung pulse is large and empty like feathers touching skin. White and red without luster, with broken hair, means death. The true Kidney pulse beats and breaks off like repeated finger flicks against stone. Black and yellow without luster, with broken hair, means death. The true Spleen pulse is weak, now rapid and now sparse. Yellow and blue-green without luster, with broken hair, means death. All appearances of true organ pulses are fatal and untreatable.”
Reading note: The supplied ten months and one zang period are retained; the latter is not assigned an invented number of days.
The Yellow Emperor asked: “Why does seeing a true organ pulse mean death?”
Qi Bo said: “All five zang organs receive qi from Stomach, their foundation. Organ qi cannot reach Hand Taiyin by itself; it must come through Stomach qi. Thus each organ arrives at Hand Taiyin according to its season. Strong harmful qi means declining essential qi. In severe illness, Stomach qi cannot accompany organ qi to Hand Taiyin, so true organ qi appears alone. Alone means illness has overcome the organ; therefore death.”
The Emperor said: “Good.”
The Yellow Emperor said: “In treating illness, examine form and qi, color and luster, pulse strength or decline, and whether illness is new or old. Do not delay beyond the proper time.
Form and qi agreeing means treatable; color and luster appearing buoyantly means easy to end; pulse following the seasons means treatable; weak and slippery pulse means Stomach qi is present and treatment easy. Act at the proper time. Form and qi disagreeing means difficult; withered, lusterless color means difficult to end; a replete, firm pulse means worsening; a pulse contrary to the seasons means untreatable.
Examine these four difficulties and explain them clearly. Contrary to the seasons means a Lung pulse in spring, Kidney pulse in summer, Heart pulse in autumn or Spleen pulse in winter, arriving suspended, severed, sinking and rough. Before a true organ form appears, a sinking rough pulse in spring or summer, or floating large pulse in autumn or winter, is also contrary to the seasons.
A still pulse with hot illness, a large pulse with diarrhea, a replete pulse with blood depletion, a replete firm pulse with illness inside, or a pulse not replete and firm with illness outside are all difficult to treat.”
The Yellow Emperor said: “I have heard that deficiency and excess decide life and death. I wish to hear their conditions.”
Qi Bo said: “Five excesses mean death; five deficiencies mean death.”
The Emperor said: “I wish to hear the five excesses and five deficiencies.”
Qi Bo said: “An abundant pulse, hot skin, distended abdomen, blocked urination and defecation, and oppressed dimness are the five excesses. A fine pulse, cold skin, scant qi, uncontrolled discharge from both lower passages, and inability to take food and drink are the five deficiencies.”
The Emperor asked: “Why do some nevertheless survive?”
Qi Bo said: “If liquid and gruel enter Stomach and pouring diarrhea stops, the deficient person lives. If sweat emerges and the bowels open, the excessive person lives. These are the signs.”
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