Ancient Wisdom: Assessing and Treating Illness Through Body Insights

The Yellow Emperor said: “I’ve heard that the ancient masters have many insights, but these were never recorded in their writings. I would like to hear and firmly remember them, so I can follow them as guidelines for treating the people’s ailments on a grand scale and for maintaining my own health on a smaller scale. This way, the people will not be burdened by sickness, harmony will prevail between the ruling and the ruled, and future generations will not have to worry about illness. I hope these teachings can be passed down through the generations as a constant guide. Can you tell me these insights?”

Qi Bo replied: “Your thoughts are truly profound! Whether it’s treating the people, oneself, or even a kingdom or family, no method that goes against the natural order has ever been successful. Only by aligning with the objective laws can one succeed. By ‘aligning with the objective laws,’ I do not only refer to the balance of Yin and Yang, the meridians, and the flow of Qi and blood, but also to the way we treat the people. The key is to follow the people’s will.”

The Yellow Emperor asked: “How can we achieve this alignment?”

Qi Bo answered: “When entering a country, one must first understand the local customs and traditions. When entering someone’s home, one must be clear about their taboos; when stepping into a house, one must be aware of their manners. Similarly, when treating a patient, the doctor must inquire about what feels most comfortable for them.”

The Yellow Emperor asked: “How can we make the patient feel comfortable?”

Qi Bo responded: “For patients with Xiao Ke (消渴, xiāo kě)—a condition of excessive thirst and hunger—it is appropriate to treat them with cold methods. For diseases caused by cold pathogens invading the body, warmth is the appropriate treatment. If there is heat in the stomach, food is digested quickly, creating a constant feeling of hunger. If there is heat in the skin above the navel, it indicates heat in the intestines, leading to stool that resembles porridge. If the skin below the navel feels cold, this indicates cold in the intestines, causing abdominal rumbling and diarrhea. If there is cold in the stomach and heat in the intestines, bloating and diarrhea will occur; if the stomach is hot and the intestines cold, the patient will feel excessively hungry, accompanied by abdominal pain.”

The Yellow Emperor said: “If the stomach is hot, cold foods should be eaten; if the intestines are cold, hot foods should be consumed. But how should we treat the opposing nature of cold and heat?”

Qi Bo replied: “Especially with nobles and officials, who are often proud and difficult to persuade, the key is to guide them carefully without going against their will. If the doctor can educate them on what harms the body and what benefits it, most people will listen, even if they don’t fully understand. But it requires a respectful approach.”

The Yellow Emperor asked: “How should we treat these conditions?”

Qi Bo answered: “In the spring and summer, one should first treat external symptoms, and then address the internal root cause. In the autumn and winter, focus on treating the internal root first, followed by external symptoms.”

The Yellow Emperor inquired further: “How should we manage patients whose habits conflict with their conditions?”

Qi Bo responded: “For such patients, their daily lifestyle should be adjusted to keep the temperature moderate. In cold weather, they should wear more clothing to avoid shivering; in hot weather, they should wear lighter clothes to prevent sweating. Regarding food, they should avoid eating foods that are too hot or too cold. By maintaining this balance, the body’s true Qi will stay protected, and the pathogenic Qi will not invade and cause illness.”

The Yellow Emperor said: “The Ben Zang (本脏, běn zàng) chapter suggests that we can judge the size and condition of the internal organs by observing the body’s shape, limbs, joints, and muscles. But for nobles and officials who wish to know their own health status, and when doctors are not allowed to conduct thorough examinations, what should we say?”

Qi Bo replied: “The body’s shape and limbs, which cover the internal organs, can give us an idea of the state of the organs, but it’s not as simple as just observing the complexion.”

The Yellow Emperor said: “I understand that we can observe the condition of the internal organs by looking at the face. But how do we assess the internal organs from the limbs and joints?”

Qi Bo explained: “Among the five organs and six fu organs, the lungs are positioned the highest, like a canopy. By observing the upward and downward movement of the shoulders and the rise and fall of the throat, one can discern the condition of the lungs.”

The Yellow Emperor said: “Well said.”

Qi Bo continued: “The heart is the ruler among the internal organs. By observing the distance between the shoulder blades and the length of the sternum, one can infer the state of the heart.”

The Yellow Emperor nodded: “That makes sense.”

Qi Bo continued: “The liver, which is like a general among the internal organs, opens to the eyes. By examining the size of the eyes, one can judge the condition of the liver.”

The Yellow Emperor said: “Excellent.”

Qi Bo added: “The spleen guards the body, absorbing the essence of food and water and distributing it to various parts of the body. Therefore, by examining the condition of the lips, tongue, and taste, one can assess the health of the spleen.”

The Yellow Emperor acknowledged: “Correct.”

Qi Bo said: “The kidneys govern water and liquids in the body. By assessing the strength of hearing, one can infer the state of the kidneys.”

The Yellow Emperor said: “Well said. Now, please explain how we can assess the six fu organs.”

Qi Bo replied: “The stomach is the sea of water and grain. If the muscles around the cheeks are full, the neck is robust, and the chest is broad, this indicates that the stomach can hold a large amount of food. If the nasal passages are deep, this suggests the condition of the large intestine. If the lips are thick and the middle crease is long, this reveals the condition of the small intestine. The size of the lower eyelids indicates the strength of the gallbladder Qi. If the nostrils flare outward, this suggests the bladder is prone to leakage. A prominent nasal bridge shows the strength of the Sanjiao.”

This method of assessing the six fu organs is a general practice. When the body’s upper, middle, and lower parts are in harmony, the internal organs are in good health.