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Huangdi Neijing · The Yellow Emperor’s Inner Canon
Suwen 77 · Explaining the Five Faults
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The Yellow Emperor said: “Alas, how distant and profound! It is like looking into a deep pool or facing floating clouds. A deep pool can still be measured, but the limits of floating clouds cannot be known. The sages’ art is a model for all people. Discussion and the ordering of intention must have rules. Follow the channels, keep their numbers and continue medical practice as a support for the people. Thus the work has five faults and four virtues. Do you know them?”
Lei Gong left his mat, bowed twice and said: “I am young, ignorant and confused. I have not heard the five faults and four virtues. I compare forms and names but cite the classics emptily. My mind has no answer.”
The Emperor said: “Before examining illness, ask whether someone was once honored and later became lowly. Even without an external harmful strike, illness arises within; it is called loss of nutritive qi. One once wealthy and later poor has what is called loss of essence. The five qi linger and illness concentrates. The practitioner examines but finds it neither in zang nor fu and no change in bodily form; doubt arises and the illness cannot be named.
“The body diminishes daily, qi is empty and essence absent. As illness deepens there is no qi, with shivering and occasional fright. It deepens because defensive qi is consumed outside and nutritive qi seized within. Even a good practitioner may miss this and fail to understand the condition. This is the first fault in treatment.”
“Anyone examining illness must ask about food and drink, dwelling, sudden joy or suffering, and joy turning to suffering. All injure essence and qi; when these are exhausted, bodily form is ruined. Sudden anger injures yin, sudden joy injures yang. Counterflow qi moves upward, filling the vessels and leaving the bodily form. The ignorant practitioner does not understand supplementation and draining or the illness’s circumstances. Essential brilliance drains away daily and harmful qi gathers. This is the second fault in treatment.”
“Those skilled in pulses must know them through comparison by kinds, unusual and ordinary patterns, and unhurried discrimination. A practitioner who does not know this Way has a diagnosis of little worth. This is the third fault in treatment.”
“Diagnosis has three constants: ask about high and low status, the injury of a dispossessed lord and the wish to become a lord or king. Someone formerly honored who loses power may suffer injury to essence and spirit within even without an external harmful strike; the body will fail.”
The compressed aspiration clause is retained without inventing a different third question.
“Someone first wealthy and later poor may have scorched skin, contracted sinews, wilting, inability to walk and contractures even without harmful influence. If the practitioner cannot be firm, cannot move the spirit, appears weak and allows disorder to destroy the ordinary course, the illness cannot be shifted and medical work fails. This is the fourth fault in treatment.”
“In every examination, know the end and beginning and understand what remains of the course. Feel the pulse, ask its name and take account of male and female.”
“Separation, severance, pent-up binding, worry, fear, joy and anger empty the five zang; blood and qi leave their guard. If the practitioner cannot know this, what art can be discussed?”
“One formerly wealthy suffers great injury, as though sinews were cut and vessels severed. The body moves again, letting moisture continue without rest. Injury, damage and binding remain and press, returning toward yang; pus accumulates with cold and heat. The crude practitioner repeatedly needles yin and yang. The body comes apart and the four limbs cramp. Death has its appointed day, but the practitioner does not understand or ask how it arose, merely speaking of the death date. This too is crude attention. It is the fifth fault in treatment.”
The damaged opening about former wealth, injury and continuing moisture is retained at its literal level, without inventing a physical intervention or a missing cause.
“All five arise from receiving the art without comprehending it and failing to understand human affairs.”
“Thus it is said: sages treating illness must know heaven and earth, yin and yang, the ordering of the four seasons, the five zang and six fu, female and male, exterior and interior, needling, moxibustion, stones and the principal uses of potent medicinals. Through unhurried attention to human affairs, they clarify the channel Way. High and low status, poverty and wealth each have different conditions. Ask about youth and age, courage and fear; carefully examine the divisions and know the illness’s original beginning. With the eight correct influences and nine indicators, examination must accord.”
“In the Way of treating illness, internal qi is the treasure. Follow and seek its principle. If it cannot be found, the error lies in exterior and interior.”
“Keep the numbers and base treatment upon them; do not lose the principles of the transporting points. One able to practice this art avoids peril throughout life.”
“Without knowing the transporting points’ principles, heat becomes pent in the five zang and abscesses erupt in the six fu. Inaccurate examination is called losing the ordinary rule. Carefully keep this treatment and illuminate it together with the classics.”
“The upper and lower classics measure yin and yang, the unusual and ordinary, and the five centers. Decide through the Hall of Light and examine beginning and end; then one may apply the art broadly.”
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