Nurturing life through the body, heart, and spirit with the wisdom of Chinese medicine


A collection of notes on the topics of classical Chinese, medicine, and traditional culture.

This blog is a collection of ruminations, translations, and personal opinions by Sabine and some guest authors. Reflecting my own personality, some posts are academic, some clinical, and some personal, some are excerpts from existing books and some may become part of future books. Please leave comments with feedback, questions, constructive criticism, and differences of opinion as long as you argue your reasons for disagreement logically. Any personal attacks, uncivil remarks, or self-promoting comments will be deleted.

Look through the Archive by Topic or Search the Blog:

Ruminating on Suwen 5... Again...

In an escape from current politics and to regain my balance and faith in humanity, I have been burying myself once again in Suwen 5, which may or may not evolve into the next book-length publication by Happy Goat Productions. What follows is probably the nerdiest blog post I have ever written, but it has brought me great satisfaction. Feel free to share constructive criticism, questions, or any other feedback in the Comments section below. I am perfectly aware that I am trying to put something in written words that is ultimately better approached intuitively. The passage below is found about two thirds through the chapter, following directly after the famous passage where Qi Bo explains the associations of the five directions with the dynamic agents, organs, climatic factors, sounds, flavors, etc etc. I am aware that the references to traditional gender roles in my discussion below may strike some readers as offensive, but I ask you to reserve judgment that comes from a modern Western perspective. Yes, I have opened another can of worms there and I promise to address that can in a different blog post in the future.

Suwen 5, Section Twelve

Translation of the Original

1) Therefore it is said: ‘Heaven and Earth! They are the up and down of the myriad things. Yīn and yáng! They are the male and female of blood and qì. Left and right! They are the path of yīn and yáng. Water and fire! They are the evidence and portents of yīn and yáng. Yīn and yáng, they are the potential and the fetal beginning of the myriad things.’
2) Therefore it is said: ‘Yīn, being on the inside, is the safe-keeper of yáng. Yáng, being on the outside, is the executor for yīn.’”

Translation Notes

•    上下: Alternatively, we can also read these two characters as actions, in the sense of “ascending and descending.” In a more elegant and less literal interpretation than what I have given above, we can translate this entire phrase as “Heaven and earth are what is above and below the myriad things.”
•    According to Zhāng Zhìcōng’s commentary, left and right are the manifestation of the diurnal circulation of yīn and yáng inside the human body.
•    陰陽之徵兆:According to Wáng Bīng, 徵 is identical with 信 in the sense of proof, evidence, sign, while 兆 is equated with 先 “ahead of time.” In other words, yīn and yáng, in their manifestation in the body as heat and cold, are the visible evidence, the manifestation, of the state of yīn and yáng in the body, as well as the advance signs of more serious illnesses to come if they are not addressed and corrected in due time.
•    The meaning of 能始, while looking quite straight-forward at first when translated as “able to begin,” can become much more complicated when we contemplate a possible relationship to this line from a Commentary on the Yi Jing (Classic of Changes) 《易經﹒系辭上傳》 : 乾知大始,坤作成物。乾以易知, 坤以简能。 “Qian (symbolizes Heaven, which) directs the great beginnings of things; Kun (symbolizes Earth, which) gives to them their completion. It is by the ease with which it proceeds that Qian directs (as it does), and by its unhesitating response that Kun exhibits such ability” (Translation by James Legge). Read in this context, 能 refers to the yīn potential that brings things to completion, while 始 refers to the generative force of yáng. Another possibility would be that 能 is the hidden potential before it is made manifest at all, like the seed lying stored underground in winter, while 始 is the actual beginning, the fetus taking shape in the womb (hence the “woman” radical 女 of the character) or the seed that is beginning to sprout and burst through its hull. Interestingly enough, the parallel passage from Sù Wèn 66 cited below here replaces this phrase 能使 with 終始 "beginning and end" and relates it to wood and metal, and their respective actions of "sprouting" or giving birth (in the spring) and bringing to completion or maturing (in the fall).

Related Passage

Quotation from Sù Wèn 66:
This being so, Heaven and Earth are the above and below of the myriad things; left and right are the pathways of yīn and yáng; water and fire are the evidence and portents of yīn and yáng; metal and wood are the end and beginning of creating and bringing to completion. Qì can have quantity or scarcity, the outer form can have exuberance or debilitation, above and below beckon each other, and losses and gains become ever so apparent!” 


To properly understand Line One, it is necessary to consider the different possibilities for interpreting paired noun phrases in literary Chinese. For this purpose, let us look at some common examples. Most directly, we can read a pair of two characters as simply a combination of two nouns in a relationship of coordination, such as the compound 血氣, meaning “blood AND qì.”  A bit more complicated is the compound 精氣, which can be interpreted variously as “essence AND qì” or, in a relationship of subordination, as “essential qì.” In other words, we can read it as a combination of two juxtaposed nouns of equal weight, or we can read it as a combination of what we would in English consider an adjective (精 “essential”) and a noun, where the first character modifies the second character (氣 qì). Lastly, a combination of two equally weighted nouns can assume a meaning that is greater than the sum of its parts. As such, the compound 天地 “heaven and earth” means more than just heaven above and earth below, but refers to  the universe as a whole, encompassing an unfathomable number of microcosms. 

In Line One above, it might be helpful to keep all of these possibilities in mind as we contemplate the meaning of the various noun combinations. As elsewhere in this chapter and the Nèijīng in general, more complicated physiological or pathological correlations are often preceded by more straight-forward and immediately graspable relationships in the natural world, at least from my personal perspective as a farmer.  As such, the first pair, heaven and earth are directly correlated with above and below, in a relationship that is intuitive to anybody who can look up at the sky and down at the dirt beneath their feet. The second correlation of yīn and yáng with “the male and female of blood and qì” takes Qí Bó’s answer to a whole new level by addressing the relationship of qì and blood in the microcosm of the gendered human body.  When first reading this line as a contemporary practitioner of Chinese medicine, it is tempting to interpret it in light of the standard treatment rule that became widely accepted and quoted from the Sòng period on: “As a general guideline on treating disease, first discuss the aspect that [the patient] is ruled by. In men, attune their qì; in women, attune their blood” (《婦人大全良方》, vol. 1「大率治病,先論其所主。男子調其氣,女子調其血。」). Nevertheless, we must remember that this gender-specific association of men with qì and women with blood was not stated, at least explicitly, prior to the Sòng dynasty. In that case, how else are we to read this statement that “Yīn and yáng! They are the male and female of blood and qì”? Should we perhaps read “male and female” in a more general sense as the totality of all humans? And does the phrase “blood and qì” perhaps refer more generally to everything that moves inside the human body? Or shall we associate yīn with blood with female, and yáng with qì with male, as many later commentators have done and contemporary TCM theory would suggest? And what does this expression actually mean, the “male and female of qì and blood”? The association of yīn with being inside and with 守 (“safe-keeping”)  and of yáng with being outside and with 使, with being dispatched, running errands, acting as “executive,” is explicitly stated in the following line (see below). Reading that line in light of the traditional male and female roles in early Chinese society certainly sheds light on the two terms 守 ”safe-keeper” and 使 ”executor.”  My best guess is that the “male and female” as the yīn and yáng aspects or functions of blood and qì can indeed be understood in light of the gendered roles of men and women in early Chinese society. Here it was normative behavior, especially in the elite literate scholar-bureaucrat circles that composed the Néijīng, for the men to leave the home and “run errands,” or in other words serve the government in the outside world, often in far-away places, while the women stayed in the ancestral home of the family to bear and raise children and take care of elders in the extended patrilineal family. Unfortunately, it exceeds the limitations of this discussion here to explore the traditional associations of “male” and “female” in early Chinese society, ritual, and philosophy in detail, but this topic has been covered by many other scholars elsewhere. We can also just consider “male” and “female” here in terms of the natural reproductive functions and physiological (and pathological) associations of male and female bodies.

Similarly, I encourage the reader to contemplate the potential meanings of the following pairings from a variety of angles instead of just reading over them quickly. “Left and right” -- is this a reference to the flow of yīn and yáng qì in the human body? Or to the movement of heavenly bodies, the rising and setting sun and moon in particular, from the perspective of the ruler facing south? The answer should always be yes and yes, and to innumerable other microcosms that we simply may not think of in the current moment. “Water and fire” -- does this refer here to the vertical polarity between the kidney and the heart in their physiological functions, to the pathological manifestations of excess yīn and yáng, to the two most basic life-giving forces in the universe that form the foundation for all creation “under Heaven” in their downward-streaming and upward-flaring activity respectively, or does it serve as a short-hand here for the Five Dynamic Agents 五行? Sometimes, I feel that the longer I contemplate the deeper meanings of a passage like this, the more I learn and yet the less I understand. Other times, I can see clearly that it does increase my comprehension of the qì-blood dynamic to utilize the lens of a yīn-yáng duality, whether they are in a healthy state of equilibrium or in a pathological imbalance with an excess of one or the other, along the lines suggested in this short passage.

Moving on to Line Two, this is one of the most important lines in this entire chapter and perhaps in the Yellow Emperor’s Inner Classic as a whole. It is also the perfect example of why it is essential to combine a thorough sinological training in the foundational historical literature with a clear understanding of grammar, as well as an appreciation for the meaning of any particular line in the context of its source text. Unschuld’s translation of this line reads, “The yīn is inside, it is the guardian of the yáng. The yáng is outside, it is employed by the yīn.” While this translation dovetails the parallelism of the Chinese text nicely and certainly works grammatically, the last phrase, and especially the term “employed” reads a bit odd when we consider the nature and functioning of yīn and yáng in the universe and in the microcosm of the social realm, especially in the context of male-female relationships in a Confucian patriarchal and patrilineal system, or in their role in the human body, for that matter.  The character 使 as a verb can mean “to cause somebody to do something,” but conceptualizing yáng as doing the bidding and following the orders of yīn is problematic. Perhaps a better way to read 使 here is in the sense of “to make something happen,” to “cause something to happen.” As such, yáng is the active half in the yīn-yáng pair, the entity that performs tasks, in the sense of the executive branch of government. Quite differently, Elisabeth Rochat de la Vallée translates this line as “Yin is on the inside but yáng keeps it there; yáng is on the outside but yīn sends it there.” She then explains that the association of “guard and defence” with yáng qì is related to its location on the outside (presumably through its role as wèi qì 衛氣, defense qì). This interpretation makes even less sense to me and also does not fit into the clear grammatical structure of the sentence. It is essential that we read 守 here not as “defense” in the sense of a guard on the exterior that protects the interior from outside invasions. As Rochat de la Vallée recognizes, this is clearly a function that is associated with yáng in Chinese medicine under the concept of wèi qì. By contrast and as suggested by the etymology of the character 守 (a hand under a roof), this action of yīn connotes “keeping [something or somebody] close-by,” attending to or keeping watch over, or in my translation above “safe-keeping,” which may sound similar in English to Unschuld’s translation of “guard” but implies a completely different function in the present context. Here, it is better to think of yīn in the role of the ideal wife who stays “under the roof,” i.e. in the home, takes care of the young and old in the family, ensures the survival and continuation of the lineage, and provides an anchor or safe harbor for the husband to return to and recharge, so that he can continue going out and performing his executive 使 functions.