On Studying the *Neijing*
The Neijing is the foundational theoretical canon of Chinese medicine. How exactly to take it, and how to study it — through the ages views have differed.
In beginning to study the Neijing, the first step is to recognize the characters and parse the sentences. Only when the Neijing's difficult characters and sentences are understood and can be spoken through can their meaning be grasped. This first step is not easy; one generally needs a teacher's guidance. For example the character jiǒng 炅 — sounded gui, also read jiǒng — describes the upward leaping of fire; without this, "jiǒng then qi outflows" cannot be understood.
The second step calls for going deeper, and going deeper depends on memorization. The famous chapters — Discourse on the Heavenly Innateness of High Antiquity, Discourse on Generation Connecting through Heaven, Great Discourse on the Four Qi Regulating the Spirit, Discourse on the True Words of the Golden Coffer, Great Discourse on Yin-Yang Imagery and Correspondence, Discourse on Cough, Discourse on Bi (impediment), Discourse on Malaria, Discourse on Regulating the Channels — and the maxims throughout, whether on theory or on disease pattern, must all be carefully committed to memory. Day in, day out, comprehension comes. Take Discourse on Different Methods Fit for the Place: it says that East, South, West, North, and Center — the five quarters — have different soils, and so different diseases, and so the methods of treatment must differ. Grasp this chapter deeply, and you will have your bearings in treating illnesses of different regions.
The Neijing mostly addresses human physiology and pathology. Defining the five storehouses from the four seasons; speaking of pathology from physiology — this is its greatest feature. For example, the Neijing says "vigorous fire eats qi" — to eat qi is to consume qi; "lesser fire engenders qi" — lesser fire is yang qi. Lesser fire is like the warmth of spring: spring warmth, growing the ten thousand things — this is lesser fire. Vigorous fire is like the summer heat: in summer the damp heat flows molten, can consume qi — this is vigorous fire. So if a person keeps the spring qi of life, illness is easy to cure; once the lesser fire becomes vigorous fire and consumes qi, the illness is grave. Thus lesser fire refers to physiology, vigorous fire refers to pathology; these two lines speak of both, and contain diagnosis and treatment as well. The physician's task is to keep the body's spring-qi always present, so vital activity goes on unbroken. The folk saying "spring is in the air" speaks to this. Only by understanding such physiology and pathology can the Neijing be well studied.
Another example: the Neijing phrase "excess does harm — the next phase restrains it" (kang hai cheng zhi) — most scientific, fine in its discussion of physiology and pathology. Excess does harm is vigorous fire, pathology; but with the next phase taking it up, excess is restrained — physiology. Water restrains fire, and fire does not become too vigorous; metal restrains wood, and wood does not exceed — this is succession then restraint.
The Yijing says: "How great is qian-yuan — the source of the ten thousand things!" and "How great is kun-yuan — the engenderer of the ten thousand things!" Without winter's frost, there is no spring's life-force. Source and engenderer, yin and yang as roots of each other — the ten thousand things, none lack this. In nature, without autumn coolness to succeed-and-restrain summer heat, the heat must turn pestilent and harmful. With heat comes cold; without frost no spring. The four-season climate — spring, summer, autumn, winter — is exactly excess and harm, succession and restraint. The principle in it is nothing but the two words yin and yang, and physiology and pathology are wholly contained in them. So I hold that students of Chinese medicine should study the Neijing — not just physiology, pathology, and anatomy in isolation. Only by awakening upon this is one a true TCM practitioner.
The Neijing contains thirteen formulas; their use is striking and should be remembered, then summarized through clinical observation. Take the Si Wuzeigu Yi Lurushe Wan (Four-Cuttlefish-Bone One-Madder Pills), from Suwen · Discourse on Abdominal Disorders, treating women's blood withering with irregular menses. This formula may be transferred to fallopian-tube stricture. Wuzeigu (cuttlefish bone), salty and warm, can open channels and dispel cold; good at breaking concretions. Lushe — today's qiancao (madder) — can open the channels. Que luan (sparrow eggs), sweet and warm, most able to invigorate sexual function. Bao yu zhi (abalone juice) is a blood-and-flesh substance, supplementing not only by flavor but by entering the liver and scattering blood; its rank-fishy smell can guide the other drugs into the womb — the principle of like attracts like. The four together truly invigorate yang and open blockage, free and transform accumulations.
Once in Indonesia, I treated a woman of twenty years' marriage who had long not conceived. Western diagnosis: left fallopian-tube stricture and blockage. She sought my treatment. After long thought, I gave this formula. After two months, X-ray showed the left fallopian-tube blockage cleared.
Likewise, the Ji Shi Li (chicken-dung wine) formula in the same chapter — someone has tested it, and its diuretic effect is striking. We see the ancients' formulas are indeed summaries of experience. In reading, do not lightly pass over such places.
Studying the Neijing, one must know that, though it has links to the later formula books, the differences too are obvious. Do not force comparisons. For example the six channels of the Shanghan Lun are quite different from those of the Neijing; forcing them together only confuses, helping neither study nor clinic.
Studying the Neijing, grasp yin-yang and you grasp the central thread. Yin-yang is a scientific objective existence, an ancient plain dialectics. Yin-yang is clearest in the Yijing: "One yin, one yang is the Way." The famous physicians of the past mostly studied the Yijing. Today we have dialectical materialism — far more scientific and superior to the ancients. So I hold one must study dialectical materialism — only then can the Neijing be truly understood.